Frozen Shoulder

Frozen shoulder is also known as adhesive capsulitis and the two terms are used almost interchangeably. The problem of frozen shoulder can start quite quickly after an injury or a frozen shoulder may sometimes develop more gradually without any obvious trigger.

Doctor's first recognised adhesive capsulitis in the late 1800's when they realised that it was a different condition from arthritis of the shoulder. Let me repeat this for emphasis: 

Frozen shoulder is not a form of arthritis and it does not develop into arthritis.

A frozen shoulder can cause severe shoulder pain and pain that spreads down the arm towards the elbow or the wrist. Most frozen shoulder pain patients are frustrated by the stiffness in the shoulder joint but it is pain relief that they seek - most say that they could live with the stiffness if the pain went away.

One of the earliest experts to devote attention to adhesive capsulitis was an American orthopaedic expert called Codman. When he wrote a large textbook on shoulder pain in the 1930's he only devoted a few pages to the subject of frozen shoulder, saying that frozen shoulder was common, but little was known about the cause or the problem inside the joint. Things have changed a lot in medicine since 1930 but doctor's still don't have a clear answer to the question of what triggers the process that leads to a frozen shoulder.

About twenty years after Codman first wrote his textbook, another doctor called Nevasier tried to perform surgical operations on the shoulders of patients who were suffering from frozen shoulder. During his attempts he found that the gristly capsule around the joint was stuck to the bone surface. He had to peel it away like a bandaid or elastoplast strip. Because of this he coined the name Adhesive Capsulitis. The terms frozen shoulder and adhesive capsulitis have been used interchangeably ever since.

Inflammation anywhere in the body causes stickiness. The cells that control the inflammation process trigger a reaction in the tissues of the body and tend to cause adjacent bits to stick to each other - not usually on a permanent basis but certainly for some weeks or months.

Now - a capsule of gristle surrounds the shoulder joint and the capsule has a little flap or bag that hangs down into the armpit. If this little bag fills up with sticky fluid then the sides of it will stick together - making it very difficult to lift your arm above your head.

If the front of the capsule sticks itself to the bone of the upper arm then you will find it nearly impossible to rotate your arm properly - especially if you are trying to reach round into your back pocket if you're male, or to fasten your bra if you're a woman.

Add some general sticking of the area around the shoulder muscles and tendons and you can surely now see why the shoulder seems to freeze up and stiffen. It's quite literally stuck with a kind of natural glue! Adhesive Capsulitis indeed.

The end result of the frozen shoulder process is that the capsule around the joint shrinks or contracts and stays tight and stiff for many, many months before it gradually recovers.