Frozen Shoulder (Adhesive Capsulitis)
Department of Interventional Pain Management | AREVA Hospital
Monday to Saturday: 10:30 AM to 1:00 PM & 5:00 PM to 7:00 PM
Phone: +91 799 0420 149 (By Appointment)
Shoulder pain is a common problem that can affect people of all ages. It may develop suddenly following an injury or gradually due to overuse, inflammation, age-related changes or problems involving the shoulder joint and surrounding soft tissues.
Pain may be felt in the shoulder itself or may extend into the upper arm, neck or upper back.
Causes & Risk Factors
- Frozen shoulder (adhesive capsulitis) – A painful condition in which the capsule surrounding the shoulder joint becomes inflamed and gradually tightens, causing increasing pain, stiffness and significant restriction of shoulder movement. It can make everyday activities such as reaching overhead, dressing or moving the arm behind the back difficult. Pain is often worse at night and may disturb sleep.
- Frozen shoulder is more likely to occur in people with diabetes, thyroid disorders, or a previous shoulder injury or surgery. It is most commonly seen between the ages of 40 and 60 years and is uncommon in younger people. Women are affected somewhat more often than men, and people with diabetes have a higher risk of developing frozen shoulder.
- Shoulder Osteoarthritis (OA) – A degenerative condition in which the cartilage within the shoulder joint gradually wears down, leading to pain, stiffness and reduced range of movement. Pain may worsen with shoulder activity and can be accompanied by grinding or clicking sensations, tenderness and difficulty with overhead or everyday movements.
- Rotator cuff injury or tears – An injury affecting the group of muscles and tendons that stabilize and move the shoulder, often caused by overuse, repetitive overhead activity, age-related degeneration or sudden trauma. It can cause shoulder pain, weakness and difficulty lifting or rotating the arm, with pain often worsening during overhead movements or at night.
- Sports or overuse injuries – Excessive training or sudden increases in physical activity can strain the muscles, tendons and other structures around the shoulder, leading to pain, inflammation, stiffness and reduced movement. These injuries are particularly common in activities involving repetitive overhead movements, throwing or heavy lifting.
Symptoms
- Pain in the shoulder, may radiating towards the neck or upper arm
- Pain while lifting or reaching overhead, while combing hair
- Pain while sleeping, especially when lying on the affected side
- Shoulder stiffness or restricted movement
- Difficulty in reaching behind the back, especially while dressing
- Weakness of the shoulder or arm
- Clicking, catching or grinding sensations
- Swelling or tenderness around the shoulder
- Difficulty performing daily or sporting activities
How Frozen Shoulder (Adhesive Capsulitis) is Diagnosed?
Diagnosis usually begins with a detailed medical history & clinical examination,
Your doctor may assess shoulder movement, strength, tenderness, stability and the specific movements that reproduce your pain.
Depending on the suspected cause, investigations may include:
- X-ray – to assess bones, joint space & arthritis
- Ultrasound – to evaluate tendons, rotator cuff, bursae & other soft tissues
- MRI – to assess rotator cuff tears, labral injuries, cartilage & other deeper structures
- Blood tests – when an inflammatory or systemic condition is suspected
Treatment Options for Frozen Shoulder (Adhesive Capsulitis)
Conservative Treatment
Activity modification – Reducing or modifying activities that aggravate shoulder pain.
Pain-relieving medications – Anti-inflammatory, analgesic & antispasmodic medicines having good role in acute stage. They reduce inflammation, pain & spasm in the shoulder, help you to get to the daily routine.
Muscle strengthening – by Physiotherapy and targeted exercises
Heat or cold therapy
Posture and movement correction
Interventional Treatment
The injection is often performed image-guided (C-ARM or IITV) to accurately position the needle within the joint. By reducing inflammation, it can help improve pain, joint movements & day-to-day function.
The injection is often performed image-guided (C-ARM or IITV) to accurately position the needle within the joint. It reduces shoulder pain and stiffness. It provides long lasting relief by allowing patients to participate more comfortably in physiotherapy and rehabilitation.
Hydro-dilatation – It is a minimally invasive procedure used to treat severe shoulder stiffness, most commonly frozen shoulder. Performed image-guided (C-ARM or IITV) to accurately position the needle within the joint, doctor injects a mixture of a corticosteroid & a large volume of sterile saline (30-40 ml) directly into the glenohumeral joint space.
This fluid creates high pressure that physically stretches, expands, and breaks down the tight, scarred joint capsule from the inside out.
The procedure can help reduce pain, improve shoulder movement and facilitate physiotherapy and rehabilitation.
Manipulation Under Anaesthesia (MUA) – It is a procedure used mainly for severe frozen shoulder with significant stiffness and restricted movement that has not improved adequately with conservative treatment. Under anaesthesia, the shoulder is carefully moved through controlled ranges of motion to stretch the tight joint capsule and improve mobility.
It can help restore shoulder movement and reduce stiffness, allowing rehabilitation to progress more effectively.
At AREVA At AREVA, we evaluate shoulder pain to identify the cause of discomfort, stiffness and restricted movement. Depending on the diagnosis, treatment may include medication, physiotherapy, image-guided shoulder injections, hydro-dilatation for selected cases of frozen shoulder and suprascapular nerve blocks for appropriate patients. Our goal is to relieve pain, improve shoulder mobility and help patients return to everyday activities with greater comfort.
Consult with Dr. Mehul Kubavat
FIPM Germany, FPCI Mumbai | Non-Surgical Spine & Interventional Specialist