Frozen shoulder (adhesive capsulitis)
Why is my shoulder so stiff that I cannot reach behind my back?
Painful stiffening of the shoulder joint capsule. Treatment is matched to how irritable the shoulder is at each stage.
What it feels like
A gradual onset of shoulder pain, often worse at night, followed by stiffness that limits reaching overhead, out to the side and behind your back, especially turning the arm outwards. Both active and assisted movement are restricted.
What is actually happening
In adhesive capsulitis the capsule around the shoulder joint becomes inflamed, then thickened and tight. It is more common between 40 and 65 and in people with diabetes or thyroid conditions. It typically moves through a painful phase, a stiff phase and a recovery phase, and the whole course can last many months.
How it is assessed
Assessment compares active and assisted movement in every direction, because a frozen shoulder restricts both, while rotator cuff problems usually do not. It also gauges how irritable the shoulder is, which guides how firm treatment should be, and screens the neck.
How it is treated
The adhesive capsulitis clinical practice guideline recommends education and stretching matched to the shoulder’s irritability, and suggests joint mobilisation may also help. In the painful phase, gentle movement within comfort is preferred over forceful stretching. A corticosteroid injection given by a physician, combined with mobility exercise, can give short-term relief, and I can discuss referral if pain is limiting progress.
What to do first
Keep the shoulder moving gently within comfort every day rather than resting it completely, and support the arm on a pillow at night. Have it assessed, and see your doctor if you have diabetes or thyroid symptoms that are not being managed.
Where this is assessed
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
References
This page is based on the following clinical practice guidelines and research.