Frozen Shoulder

Frozen Shoulder

Frozen shoulder, medically known as adhesive capsulitis, is a condition characterised by stiffness and pain in the shoulder joint.

Over time, the shoulder becomes very hard to move. While the exact cause remains unclear, it often affects people aged between 40 and 60 and is more prevalent in women than men.

Causes of Frozen Shoulder

The shoulder is a ball-and-socket joint made up of three bones: the humerus (upper arm bone), the scapula (shoulder blade), and the clavicle (collarbone). The joint is encased in a capsule of connective tissue. In the frozen shoulder, this capsule thickens and tightens around the shoulder joint, restricting its movement.

The following causes may trigger a frozen shoulder condition:

Shoulder Injury: Trauma or injury at the shoulder due to heavy lifting, falling & landing on the shoulder or weight lifting may cause shoulder injuries. Excessive exercises may also strain the shoulder muscles. 

Menopausal Syndrome: Fluctuation of estrogen hormones during perimenopause will cause stiffness and loss of suppleness in the muscles and ligaments. This can increase the chance of developing a frozen shoulder, without the need for any shoulder injuries.

Ageing: As one ages, muscles and ligaments tend to be less supple, weaker and less able to tolerate stress. Minor injuries can cause sprains and may progress to frozen shoulder condition. 


Sharp, aching pain

The pain is usually a sharp aching pain, when moving the arm. There may also be pain experienced when trying to sleep on the affected shoulder.

Limitation in movement

 As the condition progresses, there may be decreased motion of the shoulder joint. One may also experience difficulty with day-to-day activities, such as putting on clothes or brushing hair.

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Risk Factors

  • Age and gender predisposition: Most people who develop frozen shoulders are between the ages of 40 and 60. Women are more likely to develop it than men.
  • Medical conditions associated with increased risk: Individuals with certain diseases such as diabetes, thyroid disorders, or heart disease are more at risk.
  • Previous shoulder surgeries or injuries: Having had surgery or an injury that requires the arm to be immobilised can lead to a frozen shoulder.

Treatment Modalities

Pain Medication

This involves the use of medications such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), opioids, and other specialised medications designed for pain management. The type and dosage are tailored to the individual’s condition and medical history.


Minimally invasive treatments aim to effectively relieve common pain conditions by targeting pain sources.

  • Coreflex Injections: Typically contain a corticosteroid and are used for inflamed joints or tissues.
  • Platelet-Rich Plasma (PRP) injections: Utilise own platelets to promote healing in damaged tissues.
  • Intra-Articular Injections: Most commonly used to treat osteoarthritis in the hip or knee, but they can also be given in other joints, including shoulders, wrists, ankles, hands, and fingers.

For chronic pain conditions originating from spinal issues, Neurospan can be performed by our team of pain specialists from Singapore Paincare Center.

Recovery and Rehabilitation for Frozen Shoulder

Expected Recovery Timeline

Frozen shoulder typically progresses through three stages:

  1. Freezing Stage: This is the initial stage where pain gradually increases, and the range of motion starts to become limited. It can last anywhere from 6 weeks to 9 months.
  2. Frozen Stage: Pain might begin to diminish during this stage, but the shoulder becomes stiffer, and its functionality decreases. This stage can last from 4 to 6 months.
  3. Thawing Stage: The range of motion in the shoulder begins to improve during this stage. It can take anywhere from 6 months to 2 years for the shoulder to return to normal.

Importance of Physiotherapy

  • Restore Range of Motion: Through guided exercises and stretches, physiotherapy can help increase flexibility and movement in the shoulder.
  • Strengthen the Shoulder: Targeted exercises can help strengthen the muscles around the shoulder, providing better support and preventing future injuries.
  • Reduce Pain: Techniques such as ultrasound therapy or electrical stimulation can be used by physiotherapists to manage and reduce pain.

Prevention of Frozen Shoulder

Regular Shoulder Exercises

Engaging in exercises that target the shoulder can help maintain its flexibility and strength. These exercises can range from simple stretches to more structured routines that work on the rotator cuff muscles and other parts of the shoulder.

Pendulum Stretch: Stand and lean slightly forward, allowing one arm to hang down. Swing the arm gently in small circles, gradually increasing the diameter of the circles. Repeat with the other arm.

Towel Stretch: Hold one end of a towel behind your back and grab the opposite end with your other hand. Pull the towel upward with the top hand, stretching the arm behind your back.

Cross-Body Reach: Use one hand to gently pull the opposite arm across the body, stretching the shoulder.

Manage Underlying Health Conditions

Certain medical conditions, such as diabetes or thyroid disorders, can increase the risk of frozen shoulder. Regular medical check-ups and proper management of these conditions can reduce the risk.

Blood Sugar Control: For diabetic individuals, maintaining blood sugar levels within the recommended range can help prevent various complications, including musculoskeletal issues like frozen shoulder.

Thyroid Monitoring: Regularly monitoring thyroid hormone levels and ensuring they are within the normal range can help in preventing associated musculoskeletal problems.

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    Frequently Asked Questions

    Are there any specific diets or foods that can help in the prevention or management of frozen shoulder?

    While there’s no specific diet for frozen shoulder, a balanced diet rich in anti-inflammatory foods like omega-3 fatty acids, turmeric, and green leafy vegetables may help manage inflammation. It’s always advisable to consult with a healthcare professional for personalised advice.

    How often should one perform shoulder exercises to prevent frozen shoulder, especially if they are at risk?

    Regular shoulder exercises, performed 3-5 times a week, can help maintain flexibility and strength. However, the frequency might vary based on individual needs and risk factors.

    Is it common for frozen shoulder to recur in the same shoulder or affect the opposite shoulder?

    While it’s possible for frozen shoulder to recur or affect the opposite shoulder, it’s relatively rare. Maintaining shoulder mobility and strength through exercises can help reduce the risk of recurrence.

    Can frozen shoulder be a side effect of certain medications or treatments?

    Some medications, especially those that cause fluid retention or impact hormonal balance, might increase the risk of musculoskeletal issues. Speak to our doctors if you suspect a medication might be contributing to shoulder problems.