Frozen shoulder (adhesive capsulitis) is a self-limiting but stubborn condition in which the shoulder capsule becomes inflamed and contracted, severely restricting movement. Early targeted treatment shortens the course dramatically.
The Three Phases
Frozen shoulder progresses through three classic phases. The freezing phase is dominated by pain and developing stiffness. The frozen phase has less pain but profound stiffness — patients cannot raise the arm, reach behind their back or sleep on the affected side. The thawing phase is gradual recovery of motion over months. Without treatment, the full cycle can last 1–3 years.
Diagnosis
Diagnosis is primarily clinical: loss of both active and passive range of motion in a capsular pattern. Imaging (X-ray, MRI) is used to exclude other causes (rotator cuff tear, calcific tendinitis, osteoarthritis) rather than to confirm frozen shoulder itself.
Our Treatment Approach
A combination strategy yields the fastest results. Intra-articular injections (corticosteroid, hyaluronic acid or hydrodistension) directly address capsular inflammation and adhesion. Suprascapular nerve block can dramatically reduce pain. Ozone reduces inflammation and oxidative stress. Mesotherapy on the periscapular muscles relieves protective spasm. All injections are paired with a structured stretching and mobility programme — passive followed by active.
Timeline
Pain typically subsides within 1–3 weeks of starting treatment. Functional range of motion usually returns over 6–12 weeks with consistent home exercises. Diabetic patients may take longer and benefit from glycaemic optimisation alongside the treatment plan.
Risk Factors and Prevention
Risk factors include diabetes, thyroid dysfunction, age 40–60, female sex and prolonged immobilisation after injury or surgery. After any shoulder injury or surgery, early mobilisation under appropriate guidance is the best prevention.
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