Frozen shoulder

doi:10.1136/bmj.331.7530.1453

BMJ 2005;331:1453-1456 (17 December), doi:10.1136/bmj.331.7530.1453

Clinical review

Frozen shoulder

Richard Dias, specialist registrar in orthopaedics¹, Steven Cutts, specialist registrar in orthopaedics¹, Samir Massoud, consultant orthopaedic surgeon¹

¹ Royal Orthopaedic Hospital, Birmingham B31 2AP

Correspondence to: S Cutts stevenfrcs@hotmail.com

Frozen shoulder is a painful, often prolonged, condition thatrequires careful clinical diagnosis and management. Patientsusually recover, but they may never regain their full rangeof movement.

The first 150 words of the full text of this article appear below.

Introduction

Frozen shoulder is a disabling and sometimes severely painfulcondition that is commonly managed in the primary care setting.True frozen shoulder has a protracted natural history that usuallyends in resolution. In this article we consider how to diagnosefrozen shoulder and how to distinguish it from other painfulshoulder conditions. We also look at the current aetiologicaltheories and the effectiveness of conservative and operativemanagement. We reviewed the current literature on this topicand discussed papers of historical interest with consultantsin our department. We have also made reference to key paperscited in Clinical Evidence (www.clinicalevidence.com).

What is frozen shoulder?

The term "frozen shoulder" was first introduced by Codman in1934.^w1 He described a painful shoulder condition of insidiousonset that was associated with stiffness and difficulty sleepingon the affected side. Codman also identified the marked reductionin forward elevation and external rotation that are the hallmarks. . . [Full text of this article]

Who gets it?

Clinical presentation and examination

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What's the natural history of frozen shoulder?

Secondary frozen shoulder

Laboratory investigations and radiology in frozen shoulder

Pathogenesis

How should I treat it?

Treatment during the adhesive phase

Conclusions

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