Frozen Shoulder Treatment in Hyderabad — Physiotherapy for Adhesive Capsulitis
Frozen shoulder — or adhesive capsulitis — causes progressive shoulder pain and stiffness that severely limits arm movement. With the right physiotherapy at the right stage, most patients recover full movement without surgery.
Frozen shoulder (adhesive capsulitis) is a condition characterised by inflammation and fibrosis of the joint capsule of the shoulder, causing progressive pain and severe restriction of shoulder movement. It follows a characteristic natural history: freezing phase (increasing pain and stiffness), frozen phase (stiffness without much pain), and thawing phase (gradual recovery). Without treatment, the process takes 2–3 years. With appropriate physiotherapy, corticosteroid injection, and in resistant cases, hydrodilatation, recovery is significantly accelerated. Dr. Harisha (MPT) at Sri Anand CNC provides stage-specific physiotherapy for frozen shoulder.
Frozen Shoulder — Causes, Stages & Who Gets It
Freezing Phase — Weeks 1–9 (Painful Stage)
Gradually increasing shoulder pain, particularly at night. Movement begins to become restricted — especially shoulder abduction (raising the arm sideways) and external rotation (rotating the arm outward). The pain can be severe and disabling. Anti-inflammatory treatment and gentle physiotherapy are the priority at this stage.
Frozen Phase — Weeks 10–36 (Stiff Stage)
Pain decreases but the shoulder becomes profoundly stiff. Activities of daily living are severely restricted: cannot reach overhead, dress without difficulty, or reach behind the back. This is the stage for more aggressive physiotherapy — mobilisation, stretching, and strengthening exercises.
Thawing Phase — Months 9–24 (Recovery)
Gradual, spontaneous return of shoulder movement. With ongoing physiotherapy, this phase is accelerated significantly. Most patients who are treated with appropriate physiotherapy achieve full or near-full movement by the end of this phase.
Who Is at Risk?
Frozen shoulder is 2–5× more common in: people with diabetes (diabetic frozen shoulder is often more severe and recurrent), thyroid disorders, Parkinson's disease, and after prolonged shoulder immobilisation (sling after fracture, post-cardiac surgery). Age 40–60 is the peak period. Women are more commonly affected.
Conditions That Cause Similar Symptoms
Not all shoulder pain is frozen shoulder. Rotator cuff tear, shoulder impingement syndrome, acromioclavicular joint arthritis, and referred neck pain all cause shoulder pain but require different treatment. Dr. Harisha performs a detailed shoulder assessment to diagnose accurately before starting physiotherapy.
Diagnosis — X-ray, Ultrasound & Clinical Assessment
Diagnosis is primarily clinical — based on the characteristic pattern of restricted shoulder movements, particularly loss of external rotation with the elbow by the side. Shoulder X-ray rules out fracture or arthritis. Ultrasound may show capsular thickening and reduced joint volume. MRI is occasionally needed for complex cases.
Frozen Shoulder Treatment at Sri Anand CNC
Stage-Specific Physiotherapy — Dr. Harisha (MPT)
Freezing phase: gentle pendulum exercises, pain relief modalities (TENS, ultrasound, heat). Frozen phase: aggressive capsular stretching, joint mobilisation (Maitland Grade III-IV), strengthening of rotator cuff and scapular stabilisers. Thawing phase: progressive strengthening and return to full function. Full physiotherapy programme with home exercise guidance.
Corticosteroid Injection — Coordinated via Referral
A corticosteroid injection into the shoulder joint is most beneficial in the freezing phase — it significantly reduces inflammation and pain, allowing physiotherapy to proceed faster. Dr. Harisha coordinates referral for this procedure where appropriate.
Hydrodilatation (Distension Arthrogram)
In resistant frozen shoulders, hydrodilatation — injection of saline into the joint to stretch and rupture the contracted capsule — is highly effective. Combined with immediate physiotherapy, it provides rapid improvement. Dr. Harisha advises on this when standard physiotherapy is insufficient after 3 months.
Heat, TENS & Manual Therapy
Moist heat application before physiotherapy sessions increases tissue extensibility. TENS reduces pain. Manual therapy (joint mobilisation and manipulation) directly addresses capsular restriction. These modalities enhance the effectiveness of the exercise programme.
Surgery — Rare Cases Only
Manipulation under anaesthesia (MUA) or arthroscopic release is reserved for frozen shoulders that have not improved after 6–9 months of appropriate conservative treatment. Less than 10% of cases reach this stage. Sri Anand CNC provides pre- and post-operative physiotherapy.
Why Choose Sri Anand Hospital?
Treated by: Dr. Harisha · MPT (Master of Physiotherapy) · Musculoskeletal & Neurological Physiotherapy · Chanda Nagar
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