Condition
Frozen shoulder: when the shoulder becomes increasingly stiff
At first, pain at night is the main problem. Later, you notice that your arm really does move less: your hand no longer reaches behind your back, putting on a jacket becomes awkward, and even gentle movement reaches a limit. If there has been no accident, this change can be particularly difficult to understand.
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Understanding
A closer look
A frozen shoulder, called Schultersteife in German, can explain a course like this. Women are affected more often than men. The condition often requires patience and treatment suited to its current phase. At OrthoCoast, we want to work with you to establish whether you do have a frozen shoulder and what may help you in everyday life now.
What happens in the joint capsule
The shoulder capsule surrounds the joint. In frozen shoulder, it becomes inflamed, thickens and loses flexibility. This makes more than just active movement difficult: even when someone gently guides the arm, its movement remains restricted. The medical term is adhesive capsulitis.
The cause cannot always be clearly identified. Hormonal changes around the menopause are also discussed as a possible influence. Their role in an individual case is not yet certain. Frozen shoulder can also occur after an injury or operation. It is more common in people with diabetes. A coexisting condition of this kind matters for assessment and treatment, but it does not explain every individual course.
Pain and stiffness change over time
Pain is often the main feature initially, particularly at night. Stiffness increases over time. Later, the pain may decrease even though the shoulder remains significantly restricted. Only afterwards does movement often gradually become easier again. These phases overlap; they do not follow a reliable individual timetable.
Recovery can take many months or years. Full recovery by a particular date cannot be promised. Even so, you do not have to wait without support. If sleeping, dressing or working has become very difficult, practical relief and a suitable movement plan are important treatment goals.
Further information
How we distinguish the diagnosis from other shoulder problems
We discuss the onset and course of symptoms and assess both active and gently guided movements. We look at whether the restriction fits a problem with the joint capsule or whether another explanation is more likely. Osteoarthritis, tendon damage or pain coming from the neck can cause similar everyday difficulties.
An X-ray can help distinguish significant joint osteoarthritis, for example. Ultrasound or MRI is used when there are additional questions; an MRI is not routinely necessary for a typical frozen shoulder. If an older report says “periarthritis”, we clarify which finding was meant. A precise description is more helpful for further treatment than the term alone.
What may help during the painful phase
When the shoulder is very irritated, the initial focus is pain relief that you can tolerate. The medicines that may be suitable also depend on other conditions and your previous treatment. Corticosteroid treatment as tablets or a local injection may provide temporary relief in certain situations; its effects and risks must be weighed up for the particular use.
With a corticosteroid injection, possible infection and, in people with diabetes, temporarily higher blood glucose levels are relevant examples. It is not presented as a guaranteed way to shorten the whole course of the condition. After an injection of medicine at our practice, an observation period of at least 30 minutes is planned, or longer if needed. You receive advice on activity and driving or using the roads for the specific treatment.
Moving without overloading the shoulder
During a very painful phase, movement should be gentle. Forcing the shoulder beyond its limit can make symptoms worse. As irritation settles, exercises and physiotherapy support can focus more on increasing mobility.
You should understand how far a movement can go and when an exercise plan needs adjusting. Please therefore describe how the shoulder responds afterwards and during the following night. Not every demanding exercise is automatically wrong; however, persistent severe pain is not a necessary price for progress. We want to find an amount that fits your everyday life.
If the restriction persists for a long time
In many people, frozen shoulder improves without surgery. If significant limitations persist despite suitable non-surgical treatment, a specialist assessment of further options may be helpful. An operation is not an automatic consequence of having the condition for a long time; its additional benefit and risks must be weighed up.
Bring existing reports and a summary of previous treatments. It also helps to know when each movement became restricted. A shoulder that suddenly becomes hot and very swollen with fever, or a major loss of function after an accident, should be assessed urgently, even if frozen shoulder has already been diagnosed.
Frequently asked questions
Did too little exercise cause my shoulder to become stiff?
A frozen shoulder cannot simply be put down to a lack of effort. Changes in the capsule can develop without an identifiable trigger. What matters is a plan suited to the level of irritation, without blame or forced exercise.
Does less pain mean everything is back to normal?
It may indicate a change in the phase of the condition. Movement can nevertheless remain significantly restricted. These two aspects are assessed separately over time.
Do I have to stop moving completely if my shoulder is stiff?
No. Suitable movement is often part of treatment. Its extent depends on the phase and what you can tolerate. Other activities can often be continued with adaptations; the appropriate level is assessed together.
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