Frozen Shoulder, also known as adhesive capsulitis, is a condition where there is a restriction in shoulder movement. This can cause difficulty lifting your arm above your head, inability to touch the other shoulder or bring the arm backwards. Limited movement is the first sign of this condition.

Who is at risk for Frozen Shoulder?

  • It is more common in women than men.
  • It is most often seen in individuals between 40-65 years old.
  • It affects 10-20% of individuals with diabetes.
  • Shoulder immobilization due to injury, surgery or other causes can lead to this condition.
  • Conditions like hyperthyroidism, heart disease, depression, and Parkinson’s can also increase the risk of developing Frozen Shoulder.

The development of Frozen Shoulder

The exact cause of Frozen Shoulder is unknown, but it is believed to be due to inflammation that leads to thickening and tightening of the shoulder capsule. This restricts the movement of the shoulder joint. Frozen Shoulder can also develop as a result of prolonged immobilization due to reasons like a fracture or surgery. Therefore, in modern shoulder treatments, the immobilization time applied to the shoulder is minimized, and complete immobilization is being abandoned.

Frozen Shoulder typically occurs in one shoulder, but in 1/3 of cases, both shoulders may be affected.

Frozen Shoulder develops slowly and insidiously. The disease usually progresses in three stages:

Stage I: Pain is present, especially at night. There is an increase in pain along with a decrease in range of motion. This stage lasts from 2 to 9 months.

Stage II: Pain starts to decrease, and movement of the arm becomes painless. However, the range of motion is reduced. This limitation can extend up to half of the range of motion of the other arm. This stage can last from 4 to 12 months.

Stage III: Progress stops. Some patients experience a gradual increase in their ability to move. This stage can last from 12 to 48 months. In some patients, surgery may be required to regain shoulder movement during this period.

If you experience these symptoms, seek advice from an experienced orthopedist without delay. It is important to remember that starting treatment early is much more effective and simpler. After the examination, your doctor may request an X-ray. Although MR imaging does not provide significant findings in Frozen Shoulder disease, it is generally requested to differentiate other diseases that limit shoulder movement.


Treatment is determined based on the severity and stage of the disease. Treatment can be evaluated in five stages:

1- Medication and exercise therapy: Pain relievers and anti-rheumatic drugs, along with exercises taught by physiotherapists, are recommended in the early stages of the disease. The exercises may be painful, but doing them regularly can prevent the development of limited shoulder movement. Warming up the shoulder and applying heat can reduce pain and increase movement. Cold-ice application is performed to reduce inflammation after exercising.

2- Physical therapy: When there is continued limitation of shoulder movement, physical therapy should be started without delay. Shoulder physiotherapy requires special expertise and experience. Excessive strain can accelerate the disease’s progression. The treatment should be tailored to the patient’s needs, taking into account the stage and severity of the disease.

3- Steroid injections: Steroid injections may be recommended for pain relief and to reduce inflammation in the shoulder. They may be given in conjunction with physical therapy and exercise therapy.

4- Joint manipulation: Under general anesthesia, the physician manipulates the shoulder joint to break up the adhesions, which can help to restore movement. This procedure is typically performed during the second stage of the disease.

5- Surgery: Surgery may be required in some cases to restore shoulder movement. This is usually performed during the third stage of the