Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 41-02: Musculoskeletal Injuries of the Shoulder + Key Features Download Section PDF Listen +++ ++ Self-limited but very debilitating disease Caused by acute inflammation of the capsule followed by scarring and remodeling Very painful shoulder triggered by minimal or no trauma Pain out of proportion to clinical findings during the inflammatory phase Commonly seen in patients 40- to 65-years-old More common in women than men, especially in perimenopausal women or in patients with endocrine disorders, such as diabetes mellitus or thyroid disease + Clinical Findings Download Section PDF Listen +++ ++ Painful shoulder that has limited range of motion Strength is usually normal but can appear diminished when the patient is in pain There are three phases Inflammatory phase usually lasts 4–6 months; patients complain of a very painful shoulder without obvious clinical findings of trauma, fracture, or rotator cuff tear "Freezing" phase usually lasts 4–6 months; shoulder becomes progressively stiffer even though the pain is improving "Thawing" phase can take up to a year as the shoulder slowly regains its motion Total duration of an idiopathic frozen shoulder Usually about 24 months Can be much longer for patients who have trauma or an endocrinopathy + Diagnosis Download Section PDF Listen +++ ++ Usually a clinical diagnosis; an extensive work-up is not necessary However, standard anteroposterior, axillary, and lateral glenohumeral radiographs are useful to rule out glenohumeral arthritis Imaging can also rule out calcific tendinitis + Treatment Download Section PDF Listen +++ ++ During the acute "freezing" phase, NSAIDs and physical therapy are recommended Intra-articular corticosteroid injection or oral prednisone may provide short-term benefit Anti-inflammatory medication is not as helpful during the "thawing" phase as it is during the "freezing" phase Surgical treatments include manipulation under anesthesia and arthroscopic release