Frozen shoulder is usually characterised by extreme pain, which is accompanied by a progressive loss of range of movement.  This ‘freezing’ process can last several weeks to months. Following this, the painful inflammatory component can reduce but patients often still have significantly reduced range of movement, which can lead to significant disability.

It is diagnosed by taking a careful history and performing a detailed examination. This will often confirm an atraumatic history with no preceding cause. The loss of movement throughout the range is the key finding, particularly affecting the ability of the patient to turn the arm away from the body. Shoulder X-ray and MRI scans are useful to exclude other potential causes such as arthritis or another associated injury.

Treatment can begin with symptomatic management with painkillers and reassurance to patients. Frozen shoulder can improve in some cases without intervention within 2 years. However, there is often a residual loss of range of movement and the patient may have limited use of their arm for 2 years or longer. Recent evidence has suggested that ultrasound-guided glenohumeral hydrodilatation with intra-articular steroid injection, combined with physiotherapy, can successfully improve this condition. This would be the first-line treatment if a confirmed diagnosis is made and other associated causes are excluded.

When surgical intervention is required, we recommend arthroscopic capsular release. In this operation, the tight capsule is carefully and accurately released through a keyhole approach. These operations can lead to a significant improvement in a patient’s quality of life and earlier return to their normal daily activities.