Adhesive capsulitis (frozen shoulder) is a common cause of shoulder pain. It is most common in middle-aged females. The aetiology of frozen shoulder is not fully understood.

Associations

• diabetes mellitus: up to 20% of diabetics may have an episode of frozen shoulder

Features typically develop over days

• external rotation is affected more than internal rotation or abduction
• both active and passive movement is affected
• patients typically have a painful freezing phase, an adhesive phase and a recovery phase
• bilateral in up to 20% of patients
• the episode typically lasts between 6 months and 2 years

The diagnosis is usually clinical although imaging may be required for atypical or persistent symptoms.

Management

• no single intervention has been shown to improve outcome in the long-term
• treatment options include NSAIDs, physiotherapy, oral corticosteroids and intra-articular corticosteroids