Overview
Frozen shoulder, or adhesive capsulitis, is a condition characterised by progressive
inflammation and fibrosis of the glenohumeral joint capsule, leading to pain and severe
restriction of shoulder movement in all directions. It classically progresses through
three stages: the painful (freezing) phase, the frozen phase, and the thawing phase —
often spanning 18–36 months if left untreated. Interventional pain management can
dramatically shorten this timeline.
Symptoms & Causes
Common Symptoms
- Gradual onset of diffuse shoulder pain
- Progressive stiffness — difficulty with overhead, behind-back movements
- Pain at rest, significantly worse at night
- Restricted external rotation (often the earliest sign)
- Loss of active AND passive range of motion
- Difficulty dressing, combing hair, reaching seatbelts
- Muscle wasting around the shoulder from disuse
Common Causes
- Idiopathic (no identifiable cause) — most common
- Diabetes mellitus (up to 4× higher risk)
- Thyroid disorders (both hypo- and hyperthyroidism)
- Post-surgical immobilisation (cardiac, mastectomy)
- Rotator cuff injury leading to disuse
- Dupuytren's contracture association
- Prolonged immobilisation after fracture
Conservative & First-Line Treatment
- Physiotherapy — pendulum exercises, gentle passive stretching
- NSAIDs and analgesics during the painful phase
- Heat therapy before stretching sessions
- Oral corticosteroid tapering course
- Patient education on stage-specific expectations
How Vedant Pain Management Clinic Can Help
Our interventional pain specialists offer the following evidence-based procedures, all
performed with real-time ultrasound guidance for precision and safety:
- Ultrasound-guided intra-articular glenohumeral joint injection for pain and
inflammation control
- Ultrasound-guided hydrodistension (hydrodilatation) — injecting saline + steroid +
LA to stretch and rupture the contracted capsule
- Shoulder Capsule Release Adhesiolysis RFA — radiofrequency energy to release
capsular adhesions without surgery
- Suprascapular nerve block for rapid, sustained pain relief enabling physiotherapy
- Pulsed RFA of suprascapular and axillary nerves for stage 2 refractory pain
- Sequential treatment protocol designed to match your stage of frozen shoulder
Newer Diagnostic Concepts & Advances
The 'contractile frozen shoulder' subtype — characterised by progressive rotator interval
fibrosis — has been increasingly recognised. Ultrasound can now directly visualise
thickening of the coracohumeral ligament (>3 mm) and rotator interval, helping stage
the condition and guide targeted capsular intervention at Vedant Pain Clinic.
