Frozen shoulder

When the shoulder is frozen

Cleaning windows, combing hair or opening bottles – when your shoulder hurts, every movement becomes torture. 

 The shoulder experts at Schoen Clinic specialise in treating a frozen shoulder. We create an individual treatment plan together with you. So that you’ll soon be free of pain again.

Causes & symptoms

What do we understand by a frozen shoulder?

A frozen shoulder (adhesive capsulitis) is an increasing limitation of movement in the shoulder joint. Patients between 40 and 60 years of age are mostly affected. In 30 per cent of patients, both shoulders are affected, but generally not at the same time. Frozen shoulder is basically a self-limiting disease. That means it can also heal without medical treatment. A frozen shoulder takes between one and three years to heal. Ten to twenty per cent of those affected, however, retains permanent restrictions. 

A distinction is fundamentally made between primary and secondary shoulder stiffness: 
  • Primary shoulder stiffness: It is the most widespread form and cannot be traced back to any pre-existing illness or injury. 
  • Secondary shoulder stiffness: It occurs as a result of other diseases. Injuries or operations on the shoulder can also trigger secondary shoulder stiffness.

Causes of a frozen shoulder

The causes of primary shoulder stiffness are not known. Secondary shoulder stiffness can have several causes. These include shoulder injuries such as rotator cuff tear or fractures and bruises. However, operations in the shoulder area can also lead to a frozen shoulder. Some specific diseases, such as diabetes mellitus or thyroid diseases, increase the risk of a frozen shoulder.

Symptoms of a frozen shoulder

The symptoms of a primary frozen shoulder differ from the symptoms of a secondary frozen shoulder.

Symptoms of a primary frozen shoulder

A primary frozen shoulder can be divided into three phases characterised by different symptoms: 
  • Stage I (freezing initial phase): The disease begins with sudden and severe pain in the shoulder. The symptoms are particularly severe at night and it is no longer possible to sleep on the affected side.
  • Stage II (frozen, stiffening phase): The pain in the shoulder joint slowly diminishes, but mobility is increasingly limited. Particular pain is caused by external rotation and abduction of the shoulder. The limitation of the joint is most noticeable in this phase.
  • Stage III (thawing, solution phase): Shoulder mobility improves after six to 18 months. The shoulder “thaws”. In many cases, patients can move their shoulder fully again, but minor symptoms remain in some cases.

Symptoms of a secondary frozen shoulder

Secondary shoulder stiffness typically occurs after injury or surgery. Degenerative diseases of the shoulder can also lead to shoulder stiffness. In the event of a secondary frozen shoulder, phases are less clearly recognisable in the course of the disease.

Diagnostics

Diagnosis: How to recognise a frozen shoulder

A thorough patient consultation (anamnesis) takes place at the start of our diagnostics. Our shoulder specialists must precisely record the exact circumstances of the occurrence, the dynamics and your current situation. This is followed by a physical examination. The diagnosis of a frozen shoulder is usually a clinical diagnosis. 

A frozen shoulder often occurs with other structural injuries to your shoulder. Our most important task is therefore to identify the cause of your existing pain. It is often not the small tear in the rotator cuff that is responsible for your limited movement, but a frozen shoulder. 

Following the physical examination, we use imaging procedures for further diagnosis. Using magnetic resonance imaging (MRI), we see the inflammatory process in your articular capsule by administering a contrast agent.