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Causes of Frozen Shoulder

Adhesive capsulitis is a condition that causes stiffness and pain in the shoulder (glenohumeral) joint. When the connective tissue around the humeral head (the “ball” of the joint) and the glenoid (the “socket) becomes inflamed, tight, or thick, it can prevent the joint from moving freely, thus causing what’s called a “frozen shoulder”.

Although a lot is yet to be understood about when and why this condition occurs, there are some causes and risk factors that might lead to it. Let’s look at these causes in more depth.


Adhesive capsulitis can happen when the shoulder joint’s capsule (the tissues surrounding the glenohumeral joint) becomes inflamed. The body’s inflammatory response can cause this capsule to swell and thicken, preventing it from contracting and expanding during movement. 

Scarring develops at the same time, forming thick bands of tissue (adhesions), which prevent the joint’s components from moving as they should, leading to a “frozen shoulder”. 

Keeping The Shoulder Still For Too Long

Adhesive capsulitis can arise if your shoulder has been immobilized for a long period. This can happen after an injury, such as bone fractures, or after surgery that prevents you from moving your arm (i.e.: a mastectomy). 

Although immobilization is considered to be a risk factor for frozen shoulders, the link between these two health events isn’t clear. 

However, a 2016 study showed that after 2 weeks of immobilization, inflammatory cells begin to infiltrate the synovial fluid (a thick fluid between the bones that keep the joint lubricated), which starts to thicken the joint’s capsule. 

Diabetes and Other Diseases

Although the connection between diabetes and a frozen shoulder is not well understood, diabetic patients are 5 times more likely to suffer from adhesive capsulitis. 

In addition to diabetes, you might be at greater risk of developing a frozen shoulder if you have one of the following conditions:

  • Hypothyroidism
  • Hyperthyroidism
  • Parkinson’s disease
  • Cardiovascular disease

Risk Factors

Frozen shoulders can affect anyone at any stage of life, and there are no clear correlations between this condition and occupation or dominant hand. However, you may be more likely to develop adhesive capsulitis if you:

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Symptoms of Frozen Shoulder

A frozen shoulder can prevent you from moving your arm properly for several months or years at a time. However, the symptoms of this condition vary in nature and intensity depending on the stage of the disease. 

These stages are:

  • Freezing – This is the initial stage of adhesive capsulitis, and involves severe pain that intensifies during movement. Trying to avoid this pain by keeping the shoulder still causes the joint’s capsule to become thicker and stiffer, which restricts movement even further. The freezing stage can last up to 9 months. 
  • Frozen – During the frozen stage, you might experience milder pain, but your shoulder will become stiffer and unable to move freely due to the formation of thick scarring tissue around the joint. This phase lasts up to 12 months. 
  • Thawing – This is the final stage of adhesive capsulitis and can last between 5 and 24 months. During this phase, you’ll begin to regain shoulder mobility. 

Let’s look at these symptoms in more detail below.


Pain is the most prominent symptom of a frozen shoulder, and it can feel either dull or aching. The discomfort gets worse during the early stages of this condition and intensifies when moving your arm or during sleep. You might begin to feel pain radiating from the outer shoulder area into your upper arm and biceps.

Reduced Range of Motion

The pain you feel in your shoulder might cause you to avoid movement. This complication, coupled with thick bands of scarring tissues developing around the shoulder joint’s capsule, can prevent you from moving your shoulder properly. This can restrict your range of motion and impede movement, such as lifting your arm or throwing. 


During the intermediate stages of adhesive capsulitis, the adhesions around the shoulder joint begin to tie the joint’s capsule to the head of the humerus (the joint’s “ball”), preventing it from moving freely. This causes a sensation of stiffness in the shoulder and arm.

Regenerative Treatment Options for Frozen Shoulder at Orthagenex

Some of the most common treatments prescribed for adhesive capsulitis are pain relievers, non-steroidal anti-inflammatory drugs, and steroid injections. These can certainly provide short-term relief from pain – but it’s important to keep in mind that a frozen shoulder can last up to 3 years! Taking pain-killing medications daily for such long periods can expose you to significant risks, including dependency. 

Luckily, thanks to the advances in regenerative orthopedic medicine, there are other treatment options worth exploring. At Orthagenex, we have a variety of treatment options to help treat frozen shoulders.

Super-Concentrated PRP for Frozen Shoulder

Platelet-rich plasma (PRP) refers to the patient’s own blood, which has been processed to contain concentrations of platelets that are 10-40 times higher than baseline values. The use of platelet-rich plasma has received considerable interest in recent years, due to its potential for delivering growth factors to the area in need in a way that is simple, safe, and effective. 

As a form of regenerative treatment, PRP utilizes the blood’s healing factors to help the body heal itself. During PRP procedures, the platelet-rich plasma is injected into the damaged tissue, where it will have a stimulating effect on the stem cells in the targeted area. 

In regenerative orthopedics, PRP can be used to treat muscle strains, tears, ligament tears, tendon tears, minor arthritis, and joint instability, as well as conditions such as frozen shoulders. So far, there have been over 30 randomized trials confirming the benefits of PRP. In particular, for the treatment of adhesive capsulitis, patients reported a 60% improvement in diurnal shoulder pain and no night pain after just one injection of PRP. 

Bone Marrow Concentrate Stem Cell Injections for For Frozen Shoulder 

Stem cells are an essential component of the human body and play an important role in the repair of injured bones, ligaments, tendons, and other tissues. However, when we age or suffer an injury, the body may become unable to deliver enough stem cells to the area in need.

To help with this, bone marrow concentrate procedures at Orthagenex use imaging guidance to deliver concentrated bone marrow containing stem cells to the area in need. This encourages the body’s inherent ability to heal itself by replenishing cell population in the injured area.

In practice, bone marrow concentrate procedures are carried out by cannulating the bone near the pelvis with a trocar, a sharp-tipped device. This provides a narrow tunnel that can be used to collect samples of the bone marrow’s liquid component, which is rich in stem cells.

BMC procedures can assist patients in improving their shoulder health and mobility without the lengthy and painful rehabilitation periods associated with surgery.




PRP and BMC procedures can help ease the pain, stiffness, and reduced range of motion caused by a frozen shoulder – without surgery.

At Orthagenex, our specialists use these combined procedures to design a treatment program around your needs, goals, and preferences. If you are ready to improve your shoulder’s health and function, see if you’re a candidate today!

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