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Frozen Shoulder Treatment Singapore

Frozen shoulder is a condition where the shoulder joint becomes stiff and painful, limiting movement over time. This page provides an overview of its causes, symptoms, and frozen shoulder treatment options available in Singapore to help improve comfort and mobility.

Dr. Edwin Tan

Dr. Edwin Tan

MBBS (Singapore) | MRCS (Edin) | MMed (Singapore) (Ortho) | FRCS (Edin) (TR & Ortho)

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Frozen Shoulder Treatment Singapore

Frozen shoulder, also known as adhesive capsulitis, is a condition that limits movement in the shoulder joint. It usually goes through stages, increasing in pain and stiffness over time. Although the exact cause is unknown, it is characterized by inflammation and thickening of the capsule around the shoulder joint, limiting its range of motion.

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What are the Symptoms?

Frozen shoulder typically goes through three stages, each with distinct symptoms:

Freezing phase (first few weeks to months):

  • Gradual onset of shoulder pain, often worse at night. 
  • Pain increases with movement, especially reaching to the top or back of the head. 
  • Difficulty sleeping due to pain. 

Frozen phase (4-6 months):

  • The pain may be less severe but the stiffness becomes more noticeable. 
  • Significant range of motion of the shoulder, making daily activities difficult. 
  • Difficulty raising the arm overhead or across the body. 

The melting phase  (6 months to 2 years or more):

  • Gradual improvement in range of motion and reduction in stiffness. 
  • The pain subsides over time. 
  • Full recovery of movement may not always be achieved, but significant improvement is usually seen.

What are the Causes & Risk Factors of Adhesive Capsulitis?

The exact cause of frozen shoulder is not fully understood. However, several factors are believed to contribute to its development:

  • Trauma or injury: Injuries to the shoulder, such as a fracture, dislocation, or rotator cuff tear, can increase the risk of frozen shoulder, especially if proper healing and rehabilitation is not followed.
  • Surgery: Surgical procedures on the shoulder joint can sometimes lead to scar tissue formation and capsular tightening, which contributes to frozen shoulder.
  • Immobilization: Prolonged periods of immobilization, such as after a fracture or surgery, can cause stiffness and potentially lead to frozen shoulder.
  • Certain medical conditions: Diabetes, thyroid disorders, and Parkinson's disease are associated with an increased risk of developing frozen shoulder.
  • Autoimmune diseases: Some autoimmune conditions can affect the tissues around the shoulder joint, contributing to inflammation and possibly frozen shoulder.

Predisposing factors of frozen shoulder/ People at risk

Certain factors can increase your risk of developing frozen shoulder:

  • Age: Frozen shoulder is more common in people between the ages of 40 and 60.
  • Gender: Women are more likely to develop frozen shoulder than men.
  • Diabetes: People with diabetes are at a higher risk of developing frozen shoulder.
  • Previous shoulder injury or surgery: As mentioned earlier, previous shoulder injuries or surgery can predispose individuals to frozen shoulder.

Diagnosis of Frozen Shoulder

Diagnosis of frozen shoulder usually includes:

Physical examination:

 A health care professional will examine your shoulder to identify: 

  • Location and intensity of pain: They will move the shoulder to identify the location of tenderness and assess the degree of pain. 
  • Range of motion: They will gently test the range of motion in your shoulder in different directions to assess the range of stiffness. 
  • Passive range of motion: They may gently move your arm to assess the range of motion due to stiffness. 

Imaging tests

Imaging tests are not usually necessary for diagnosis but can sometimes be helpful in ruling out other conditions: 

  • X-rays: X-rays can help identify any underlying bone abnormalities or fractures in the shoulder joint. 
  • MRI scan: In rare cases, an MRI scan may be used to look at soft tissues such as the capsule and rotator cuff for a more detailed diagnosis, especially if there is a variety of shoulder pain and stiffness. Any concerns about the underlying cause. 

Treatment options for frozen shoulder

Treatment focuses on managing pain, improving mobility, and preventing further stiffness. Here’s an overview of common

Non-Surgical Frozen Shoulder Treatment

Imaging tests are not usually necessary for diagnosis but can sometimes be helpful in ruling out other conditions: 

  • X-rays:

    X-rays can help identify any underlying bone abnormalities or fractures in the shoulder joint. 

  • MRI scan:

    In rare cases, an MRI scan may be used to look at soft tissues such as the capsule and rotator cuff for a more detailed diagnosis, especially if there is a variety of shoulder pain and stiffness. Any concerns about the underlying cause. 

• Pain medications:

Over-the-counter pain relievers (ibuprofen, acetaminophen) or stronger prescription pain medications can be used to manage pain and discomfort. 

• Pain management techniques:

Strategies such as ultrasound therapy, heat therapy, or electrical stimulation can be used to manage pain and inflammation. 

• Gentle stretching exercises:

Gentle stretching exercises to improve flexibility and range of motion in the shoulder joint. These exercises should be done within your pain tolerance to avoid further injury. 

• Strengthening exercises:

As pain and stiffness improve, strengthening exercises for the muscles around the shoulder joint, including the rotator cuff and core muscles, will be added to the program. This helps improve stability and prevent future problems. 

• Corticosteroid injection:

In some cases, injecting corticosteroids directly into the shoulder joint can relieve pain and reduce inflammation, helping with physical therapy exercises. However, repeated injections are not recommended due to possible side effects. 

• Manipulation under anesthesia (MUA):

In severe cases with significant stiffness, a healthcare professional may recommend manipulation under anesthesia (MUA). This procedure involves gently stretching the shoulder capsule while you are under anesthesia to improve range of motion. This is usually followed by intensive physical therapy to maintain increased mobility. 

Surgery:

Frozen shoulder surgery is rarely necessary and is usually only considered in rare situations when conservative treatment fails to provide significant improvement after a long period of time (usually more than a year). Surgical procedures may include: 

  • Arthroscopic capsule release:

    A minimally invasive procedure using a camera and small instruments to cut or release narrow portions of the shoulder capsule to improve mobility. 

  • Open capsule release:

    In some cases, a traditional open incision may be necessary for a more extensive release of the capsule. 
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Dr. Edwin Tan

Consultant Orthopaedic Surgeon

MBBS (Singapore), MRCS (Edin), MMed (Ortho), FRCSed (Orthopaedics & Trauma)

Frequently Asked Questions

How long does frozen shoulder take to heal?

Recovery can take several months to over a year. It typically progresses through three stages, freezing, frozen, and thawing, with gradual improvement in shoulder mobility over time.

Early signs include mild shoulder pain that worsens at night or when moving the arm. Over time, stiffness develops, making simple actions like reaching overhead or behind your back difficult.

After surgery or trauma, the shoulder joint may remain immobile during recovery. This lack of movement can cause the surrounding capsule to tighten, leading to stiffness known as adhesive capsulitis.

Yes. Non-surgical options are often the first line of care and may include physiotherapy, medication, or injections. Surgery is only discussed if symptoms persist after prolonged conservative care.

Exercises that focus on stretching and mobility, such as pendulum swings or gentle arm raises, may help. These should be done under professional guidance to avoid aggravating the condition.

Surgery is generally considered when symptoms persist for more than a year despite physiotherapy and other conservative care. It may involve releasing the tightened shoulder capsule to restore motion.

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