Frozen Shoulder (Adhesive Capsulitis) — When You Cannot Lift Your Arm
Table of Contents
What is frozen shoulder
Frozen shoulder (adhesive capsulitis) is a condition in which the joint capsule surrounding the shoulder becomes thickened and adherent due to inflammation and fibrosis, severely limiting both active and passive range of motion. It is called "50-shoulder" in Korean because it is most common in the 50s, but it occurs broadly from the 40s through the 60s. Incidence is 2–4 times higher in patients with diabetes, and after one shoulder is affected, there is roughly a 20–30% chance the other shoulder will be affected as well.
Three-stage progression
- Freezing (painful) phase, 2–9 months: Pain in the shoulder gradually intensifies, especially at night. Range of motion slowly begins to decrease.
- Frozen phase, 4–12 months: Pain lessens somewhat, but the joint stiffens, severely restricting motions like raising the arm or reaching behind the back. Daily activities such as dressing or combing hair become difficult.
- Thawing phase, 5–24 months: Range of motion gradually recovers, but without active treatment it can take years.
Differentiation from other conditions
The key differentiating feature of frozen shoulder is that not only active movement but also passive movement (when someone else lifts the arm) is restricted. In rotator cuff tears, active movement is limited but passive movement is often still possible.
Korean medicine approach
- Acupuncture: Needling around the shoulder at acupoints such as Jianyu (LI15), Jianliao (TE14), Jianzhen (SI9), and Binao (LI14) promotes blood flow around the joint capsule and helps release adhesions. Combining electroacupuncture is more effective for deep pain relief.
- Chuna manipulation: Joint mobilization techniques are applied stepwise to release the stiffened capsule. Forced stretching can worsen inflammation, so progression is gradual within the patient's pain-free range.
- Herbal medicine: Seogyeong-hwalhyeol-tang (舒筋活血湯) or Doghwal-gisaeng-tang (獨活寄生湯) is used as a base; wind-damp expelling (祛風濕) herbs are emphasized in the freezing phase, and blood-moving, stasis-resolving (活血祛瘀) herbs in the frozen phase.
- Pharmacopuncture / bee venom: Pharmacopuncture is administered directly into the adherent areas of the capsule to inhibit fibrosis, and bee venom's anti-inflammatory effect reduces capsular inflammation.
Rehabilitation exercises
Daily pendulum exercises, wall climbing exercises, and towel stretches maximize treatment effects. The key is to perform them consistently within a pain-free range.