Frozen Shoulder part 2, The phases of Frozen Shoulder


This is the second in a series on Frozen Shoulder. To read the first one, click here.

When one has Frozen Shoulder it progresses through 3 predictable phases as you can see below.   

Frozen Shoulder often produces much anxiety in a patient.  The pain and feeling of restriction is very different from any other condition and quite disconcerting.  It is helpful for patients to understand how Frozen shoulder progresses and what a person can expect over time. The phase that the shoulder is in will dictate the approach used to treat it. And, as with many conditions, the phase the patient is in when beginning treatment will have an impact on how quickly a patient recovers.

The phases of Frozen shoulder (also known as Adhesive Capsulitis) are:

Freezing (Averages 2 to 8 months untreated)

– Painful and increasingly restricted movement

– Painful with inactivity such as when attempting to sleep

– Rapid movements produce spasms and extreme pain   

– Increasingly painful stage

– Adhesions around the joint develop

Frozen  (Averages 4 to 12 months untreated)

– Notably restricted movement with some pain    

– Decreasing pain, increasing stiffness.

– Spasms decreasing or disappearing

– Mobility slowly increasing with decreasing pain

– Night pain lessens and often disappears at this stage

    –Maturation and development capsular contractures (adhesions thicken and toughen)

Thawing  (Averages 4 to 12 months untreated)

– Decreasingly painful

– Increasing mobility

The Frozen shoulder  phases do have a few distinct way-points as you see above and represent a continuum of the disease process.  Recovery of mobility (thawing) generally follows after 2 – 3 years without treatment.  However, cases have been reported to last up to 10 years. On recovery, shoulder movement may return fully, but some limitation of range of motion commonly persists.  In one study by (Shaffer 1992) involving 62 cases, half the subjects still had some symptoms at 2-11 years after diagnosis.  A comprehensive treatment plan helps reduce the overall time the patient has a painful restricted shoulder and optimizes the restoration of shoulder range of motion.  In other words, schedule an appointment for a diagnosis as soon as you have some indication that you may have Frozen shoulder!

In our next post we will discuss our treatment techniques for Frozen shoulder.  Frozen Shoulder can be treated in a variety of ways; surgery, injections, pain killers, massage, physical therapy and instrument assisted soft tissue therapy and Active Release Technique.    We are a chiropractic office and focus on the more conservative treatments, which most seem to appreciate.  More to come in our next post.

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