Frozen Shoulder - Changi General Hospital

What causes frozen shoulder?
The exact cause is unknown. The condition has been linked to auto-antibodies that attack
the joint capsule, resulting in inflammation, adhesion and eventual scar tissue formation. It
may be triggered by injury (including surgery), degenerative changes in the joint, as well
as viral illnesses. This condition is also more common in diabetics. Your shoulder may go
through several stages as the scar tissue forms, with each stage lasting between three to six
months:
1. Freezing stage—you may experience ache and mild stiffness as the disease starts. Pain
worsens as the condition progresses.
2. Frozen stage—pain diminishes but stiffness increases. Shoulder movements can be
severely restricted.
3. Thawing stage—shoulder movement improves, and you will be able to do more
activities. Complete resolution is the norm but up to 15% of patients may have remaining
movement restriction or weakness.
What will my doctor do?
After a physical examination, an ultrasound scan and X-ray may be required to exclude
other causes of pain. In the early stages, it may be difficult to tell it apart from other painful
conditions affecting the shoulder.
How is it treated?
The disease will, unfortunately, have to run its course. The goal of treatment is to minimise
pain and discomfort during the disease process and to restore full range of motion and
strength by the end of its natural course. Your doctor may prescribe a course of antiinflammatory
medication for symptom relief. Forceful manipulation should be avoided as
this may worsen symptoms. Hydrodilatation of the joint may be required in severe cases.
During this procedure, which is carried out under local anaesthesia, a small volume of sterile
solution is injected into the joint to loosen the adhesions.
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