Frozen Shoulder & Shoulder Stiffness

What is a frozen shoulder?

A frozen shoulder is a condition in which the shoulder gradually becomes painful and difficult to move. The tissues around the shoulder become tight, making it harder to lift or rotate the arm.

It usually develops gradually. Pain often appears first, followed by increasing stiffness. Over time, the pain may improve while the stiffness remains. The shoulder then gradually starts to loosen again. Recovery can take several months and sometimes longer.

Is every stiff shoulder a frozen shoulder?

No. A shoulder can become stiff for many different reasons.

A frozen shoulder usually develops gradually without a major injury. A shoulder can also become stiff after a fracture, dislocation, surgery or another injury.

These problems may look similar, but they do not always need the same treatment. Finding out why the shoulder is stiff is therefore important before deciding on treatment.

Why does the shoulder become stiff after an injury?

After an injury, the shoulder may become stiff because of pain, swelling and keeping the arm still for a long time. Sometimes the injury itself can also affect how the shoulder moves.

For example, stiffness after a broken bone or a shoulder dislocation may need a different approach from a typical frozen shoulder.

What are the symptoms of frozen shoulder?

You may notice:

• Shoulder pain

• Increasing stiffness

• Difficulty lifting your arm

• Difficulty reaching behind your back

• Difficulty dressing or putting on a shirt

• Difficulty combing your hair

• Difficulty sleeping because of shoulder pain

How is the problem diagnosed?

Your doctor will ask how the problem started and examine how much you can move your shoulder.

An X-ray may be needed to look at the bones and the shoulder joint. An ultrasound or MRI may sometimes be useful if another problem is suspected.

The aim is to find out why your shoulder has become stiff, rather than simply calling every stiff shoulder a “frozen shoulder.”

How is a frozen shoulder treated?

Most frozen shoulders can initially be treated without surgery. Treatment may include exercises, physiotherapy, pain relief and, in some patients, an injection to reduce pain and help movement.

If severe stiffness continues despite appropriate treatment, a procedure to loosen the tight tissues around the shoulder (arthroscopic capsular release) may sometimes be considered.

How is stiffness after an injury treated?

Treatment depends on what caused the stiffness. Some people improve with exercises and physiotherapy. Others may need further treatment if the original injury has affected the movement of the shoulder.

The important thing is to treat the reason for the stiffness rather than simply treating the stiffness itself.

What happens if surgery is not done?

Most frozen shoulders eventually improve without surgery, although recovery can be slow. Some people may continue to have some stiffness for a long time.

After an injury, the outcome depends on what caused the stiffness. Some people recover with exercises and physiotherapy, while others may continue to have significant stiffness despite treatment.

When can I return to normal activities?

Recovery is usually gradual and can take several weeks to several months. The time depends on why the shoulder is stiff, how severe the problem is and what treatment is needed.

After a procedure to loosen a very stiff shoulder (arthroscopic capsular release), exercises are usually started early to help maintain the improvement.

Stiffness after a fracture, dislocation or surgery may take longer to recover.

When can I return to sports?

This depends on the sport and how much movement and strength you have regained. Activities that require lifting the arm overhead should be restarted gradually.

If the stiffness followed a fracture or dislocation, you may also need to wait until the original injury has fully healed before returning to sport.

When should I see an orthopaedic surgeon?

You should consider seeing an orthopaedic surgeon if your shoulder remains painful or stiff, particularly if the problem is interfering with your sleep, work, daily activities or sports.

It is especially important to have the shoulder assessed if the stiffness developed after a fracture, dislocation, surgery or another significant injury.

You should also seek assessment if your shoulder is not improving despite appropriate exercises or physiotherapy.

A specialist assessment can help determine why the shoulder is stiff and whether you need further treatment.