Frozen Shoulder (Adhesive Capsulitis)

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Frozen shoulder, also known as adhesive capsulitis, is a condition where the shoulder becomes painful, stiff, and difficult to move. It develops when the capsule surrounding the shoulder joint thickens and becomes inflamed, gradually tightening and restricting movement.

The condition often comes on slowly and can significantly interfere with everyday activities such as reaching overhead, dressing, driving, or sleeping comfortably.

Stages of Frozen Shoulder

Frozen shoulder typically progresses through three stages:

Stage 1:

Freezing Stage

Stage 2:

Frozen Stage

Stage 3:

Thawing Stage

Increasing pain, especially at night
Gradual loss of movement

Pain may settle, but stiffness becomes more severe
Everyday activities become difficult

Gradual improvement in movement
Reduced stiffness and improving function

Without treatment, this process can take up to two years or longer.

What Causes Frozen Shoulder?

Frozen shoulder occurs when inflammation within the shoulder joint capsule leads to scarring and tightening. In many cases, there is no single clear trigger, but certain biological and mechanical factors are known to increase risk.

People more likely to develop frozen shoulder include:

Individuals with diabetes, where changes in collagen and connective tissue make the capsule more prone to tightening
Those with thyroid disorders, high cholesterol, or heart disease
Women aged 40 to 60, possibly related to hormonal changes
People who have had shoulder injury, surgery, or prolonged immobility

These factors help explain why frozen shoulder tends to cluster in certain groups rather than occurring at random.

Early Warning Signs to Watch For

Early symptoms commonly include:

Shoulder pain that is worse at night
Difficulty lifting the arm overhead
Trouble reaching behind the back
Increasing stiffness over time

When these symptoms are ignored, the shoulder may progressively stiffen, making recovery slower and more challenging. Early assessment is important.

How Is Frozen Shoulder Treated?

Most cases of frozen shoulder respond well to non-surgical treatment.

Physiotherapy

Physiotherapy plays a central role and focuses on:

Guided stretching and mobility exercises
Maintaining shoulder movement
Gradually restoring function as pain settles

Pain Relief and Injections

Pain management may include:

Anti-inflammatory medication
Corticosteroid injections to reduce inflammation and pain

Hydrodilatation, where fluid is injected under imaging guidance to gently stretch the capsule in selected cases

What to Expect During and After Surgery

During Surgery

Frozen shoulder surgery is usually a keyhole (arthroscopic) procedure performed under general anaesthesia. It is most often a day surgery, meaning you can go home the same day. The surgeon releases the tight capsule around the shoulder to help improve movement.

After Surgery and Recovery

It is normal to have some pain and stiffness in the early days after surgery. This usually improves with pain relief and movement. Physiotherapy starts soon after surgery and is very important to keep the shoulder moving and prevent stiffness from returning.
Recovery happens gradually. Most people notice improvement over weeks, with ongoing gains in movement and function over several months.

Can Frozen Shoulder Come Back After Surgery?

Frozen shoulder coming back after surgery is uncommon, especially when physiotherapy is followed closely. However, people with diabetes or other medical conditions may have a higher chance of stiffness returning or developing frozen shoulder in the other shoulder. Keeping up with exercises and seeking early treatment if stiffness returns can help reduce this risk.

How to Prevent Frozen Shoulder?

Frozen shoulder cannot always be prevented, but early action can reduce the risk of severe stiffness. Keeping the shoulder gently moving after injury or surgery, addressing shoulder pain early, and avoiding prolonged immobilisation are key. People with diabetes or other metabolic conditions should be particularly vigilant, as they are at higher risk. Seeking early assessment and starting physiotherapy when night pain or movement restriction first appears can help maintain mobility and support a smoother recovery.

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Dr Jerry Chen

MBBS (S’pore), MRCSEd, MMed (Ortho), FRCSEd (Ortho)

Fellowship-trained Consultant Orthopaedic Surgeon & Medical Director

Before starting Alps Orthopaedic Centre, Dr Jerry Chen was a Consultant at Singapore General Hospital (SGH), where he accumulated over 13 years of experience in Orthopaedic Surgery.
Dr Chen spearheaded the workgroup for Enhanced Recovery After Surgery (ERAS) for hip and knee replacement surgeries at SGH, where he successfully employed ERAS, benefiting more than 2,000 patients thus far.
Having performed over 500 surgeries in a year, he has been instrumental in helping numerous patients recover from injuries and diseases and return to their active lifestyles.
His clinical interests include Enhanced Recovery After Surgery (ERAS) for Hip and Knee, Sports Injuries, Minimally Invasive Surgery and Robotic Surgery.

Why Alps Orthopaedic Centre?

At Alps Orthopaedic Centre, we specialise in Enhanced Recovery After Surgery (ERAS). Performed as a Day Surgery, the ERAS Direct Anterior Approach in Total Hip Replacement (THR) technique as well as ERAS Total Knee Replacement (TKR), reduces the average hospitalisation stay, utilising techniques which enable the patient to suffer from less pain and recover faster. We are an Orthopaedic clinic in Singapore, which specialises in ERAS and do our utmost to enable patients to return to everyday activities as early as possible.

Our Orthopaedic clinic provides specialised diagnosis and effective treatment of musculoskeletal problems, especially Day Surgery / Enhanced Recovery After Surgery (ERAS) For Hip and Knee Surgery, Sports Injuries and Trauma Fractures. If you are considering hip or knee surgery or minimally invasive treatments, book an appointment with our experienced Consultant Orthopaedic Surgeon, Dr Jerry Chen, for a thorough assessment and treatment plan.

Our aim is to boost patient well-being, optimising every aspect of the surgical journey. By minimising the recovery period, patients are able to go back to activities that they love. The Alps team offers comprehensive financial counselling sessions to ensure our patients understand their options and make informed decisions regarding their treatment plans.

Has this article been insightful? Share it!

Dr Jerry Chen

MBBS (S’pore), MRCSEd, MMed (Ortho), FRCSEd (Ortho)

Fellowship-trained Consultant Orthopaedic Surgeon & Medical Director

Before starting Alps Orthopaedic Centre, Dr Jerry Chen was a Consultant at Singapore General Hospital (SGH), where he accumulated over 13 years of experience in Orthopaedic Surgery.
Dr Chen spearheaded the workgroup for Enhanced Recovery After Surgery (ERAS) for hip and knee replacement surgeries at SGH, where he successfully employed ERAS, benefiting more than 2,000 patients thus far.
Having performed over 500 surgeries in a year, he has been instrumental in helping numerous patients recover from injuries and diseases and return to their active lifestyles.
His clinical interests include Enhanced Recovery After Surgery (ERAS) for Hip and Knee, Sports Injuries, Minimally Invasive Surgery and Robotic Surgery.

Why Alps Orthopaedic Centre?

Has this article been insightful? Share it!

Dr Jerry Chen

MBBS (S’pore), MRCSEd, MMed (Ortho), FRCSEd (Ortho)

Fellowship-trained Senior Consultant Orthopaedic Surgeon & Medical Director

Before starting Alps Orthopaedic Centre, Dr Jerry Chen was a Consultant at Singapore General Hospital (SGH), where he accumulated over 15 years of experience in Orthopaedic Surgery.
Having performed over 500 surgeries in a year, he has been instrumental in helping numerous patients recover from injuries and diseases of the musculoskeletal system.
As a driven and valued member, Dr Chen spearheaded the workgroup for Enhanced Recovery After Surgery (ERAS) for hip and knee replacement surgeries at SGH.
Over the course of his career at SGH, Dr Chen has successfully employed ERAS and reduced the average hospitalisation stay for hip and knee replacement surgeries.
Going through these ERAS day surgeries has benefited more than 2,000 patients thus far, enabling them to suffer from less pain and recover faster.
The Alps team is committed to providing specialised orthopaedic care tailored to your unique condition. We offer comprehensive financial counselling sessions to ensure our patients understand their options and make informed decisions regarding their treatment plans.

Why Alps Orthopaedic Centre?

Our Orthopaedic clinic provides specialised diagnosis and effective treatment of musculoskeletal problems, especially Day Surgery / Enhanced Recovery After Surgery (ERAS) For Hip and Knee Surgery, Sports Injuries and Trauma Fractures. If you are considering hip or knee surgery or minimally invasive treatments, book an appointment with our experienced Senior Consultant Orthopaedic Surgeon, Dr Jerry Chen, for a thorough assessment and treatment plan.