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As mentioned in Part 1, frozen shoulder presents with 4 main stages (some say only 3, combining the second and third stage). These will be described in more detail.
- Painful stage:
- Initially the main complaint is shoulder pain, often without a history of an injury to the shoulder or overuse. This pain is usually sharp and often worse at night. During this stage, the range of movement in the shoulder is limited by pain. Because of this, the condition is often mistaken for other painful shoulder conditions such as impingement syndrome, rotator cuff tendinosis or bursitis.
- The main difficulties with function are usually reaching overhead or to the side and putting the hand behind the back
- Often lasts up to 3 months
- Pain and Freezing stage:
- During this stage, the pain continues and the range of motion in the shoulder starts to decrease. In frozen shoulder, the most affected motion is external rotation (turning the arm outwards).
- Often lasts from 3 to 9 months
- Frozen stage:
- During this stage, the pain is not as sharp and there is significant loss of range of motion
- Often lasts from 9 to 15 months
- Thawing stage:
- During this stage, the pain is less and range of motion resolves, although not completely in some
- Often lasts from 15 to 24 months, sometimes longer
Frozen Shoulder Part 4 will discuss the treatment for frozen shoulder.
Reference:
Kelley MJ et al Shoulder pain and mobility deficits: Adhesive capsulitis. J Orthop Sports Phys Ther 2013; 43(5):A1-A31.