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Frozen shoulder (adhesive capsulitis)

Tore A Prestgaard, MD
Section Editor
Karl B Fields, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM


Frozen shoulder has been defined by the American Academy of Orthopedic Surgeons as: "A condition of varying severity characterized by the gradual development of global limitation of active and passive shoulder motion where radiographic findings other than osteopenia are absent." The condition is also characterized by severe shoulder pain.

Frozen shoulder is also referred to as adhesive capsulitis, painful stiff shoulder, and periarthritis. We will use the term "frozen shoulder" throughout this review. This topic will review the diagnosis and management of frozen shoulder. Evaluation of the patient with undifferentiated shoulder pain and other specific causes of shoulder pain or dysfunction are discussed separately. (See "Evaluation of the patient with shoulder complaints" and "Rotator cuff tendinopathy" and "Presentation and diagnosis of rotator cuff tears".)


The prevalence of frozen shoulder is estimated to be 2 to 5 percent of the general population [1,2]. The condition is most common in the fifth and sixth decades of life, with the peak age in the mid-50s. Onset before the age of 40 is rare. Women are more often affected than men. The non-dominant shoulder is slightly more likely to be affected. In 6 to 17 percent of patients, the other shoulder becomes affected within five years [3].

Frozen shoulder occurs predominantly unilaterally and is usually self-limited, although evidence about prognosis is limited, and the course can be prolonged, in some cases lasting over two to three years [4,5]. Some studies suggest that up to 40 percent of patients have persistent but mostly mild symptoms beyond three years, and 15 percent have long-term disability [6-10].


Frozen shoulder can be primary (or idiopathic) but is often associated with other diseases and conditions. Patients with diabetes mellitus are at greater risk of developing frozen shoulder, with a prevalence of 10 to 20 percent [1,11-13]. The condition has also been associated with thyroid disease [14,15], prolonged immobilization, stroke, autoimmune disease, and in rare instances with Parkinson disease [16] and antiretroviral therapy (particularly protease inhibitors) for HIV infection [17-19].

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Literature review current through: Dec 2017. | This topic last updated: Aug 04, 2017.
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