Adhesive Capsulitis (Frozen Shoulder): When the Shoulder Stiffens and the Arm Cannot Be Raised

The medical name for frozen shoulder is adhesive capsulitis (frozen shoulder). As inflammation and fibrosis develop in the joint capsule surrounding the shoulder joint, pain appears, and movements to raise the arm or rotate it outward gradually decrease. It is common in people in their 40s to 60s and is known to occur more frequently in those with diabetes or thyroid conditions.

Not all shoulder pain is adhesive capsulitis. In rotator cuff tendon issues, the arm can often still be raised relatively well if another person lifts it despite pain; however, adhesive capsulitis is characterized by a reduction in range both when moving independently and when moved by another person, and this difference serves as a clue for distinction.

• Waking from sleep at night due to shoulder pain
• Movement catches and hurts when lifting the arm or rotating it backward
• When raising both arms overhead, the affected side raises less
• Difficulty dressing, undressing, or placing the hand behind the back
• Pain when reaching for objects on high shelves
• Significant surge in pain if the arm bumps against something

These items are for organizing information before consultation. Experiencing them does not confirm adhesive capsulitis.

Adhesive capsulitis often progresses through a phase where pain gradually worsens, a phase where pain somewhat decreases but stiffness becomes prominent, and a phase where movement slowly returns. Recovery usually takes over a year and in some cases up to 2 to 3 years, with the pace differing among individuals.

Forcefully bending and lifting a painful shoulder to its end range during the severe pain phase can worsen pain. It is important to set different exercise intensities and treatment goals depending on the stage.

If you cannot lift the arm at all or notice changes in shoulder shape after a fall, fractures, dislocations, or tendon tears must be evaluated. If shoulder pain is accompanied by chest pain, shortness of breath, or cold sweats, do not conclude it is a shoulder problem alone, and call 119 (Korea's emergency number) or go to an emergency room immediately.

Prompt consultation is also needed if the shoulder is red, hot, swollen, or feverish, if the arm swells and changes color, or if neck pain is accompanied by arm tingling and weakness. Those with a history of cancer or unexplained weight loss who develop severe nocturnal pain without prior trauma also need evaluation to check for other causes.

A Korean medicine doctor checks when pain began, its triggers, night pain, and underlying conditions such as diabetes. Ranges of lifting the arm forward and to the side, and rotating inward and outward, are compared between active independent movement and passive movement guided by the medical team, alongside movement of the neck and shoulder blades.

If there are no red flags, Chuna manual therapy, acupuncture, and pharmacopuncture may be considered according to the patient's condition, aiming to relieve tension in muscles around the shoulder and achieve phased recovery of range of motion. During severe pain phases, pain control and sleep take priority over aggressive range exercises; during phases dominated by stiffness, range-of-motion exercises are increased. Treatment response is confirmed by whether daily activities such as washing hair, dressing, and reaching high shelves actually become more comfortable.

Most cases of frozen shoulder can be treated at a Korean medicine clinic with Chuna manual therapy, acupuncture, pharmacopuncture, and stage-appropriate exercise. In the early stage when pain is so severe that sleep is difficult, treatments such as steroid injections are sometimes used alongside them; while they may help with short-term pain control, repeating them brings risks such as elevated blood sugar and weakening of surrounding tissues.