According to consultant orthopaedic and trauma, arthroplasty and robotic surgeon Dr Suresh George V Nainan, most cases are idiopathic, meaning there is no identifiable cause. But several studies indicate that those with diabetes are at least three times more prone to developing a frozen shoulder.

The condition is characterised by inflammation of the shoulder joint, often without any clear cause, and typically begins with progressive pain and stiffness, eventually leading to significant immobility of the joint.

From there, it progresses to the freezing stage, which lasts between two and nine months; the frozen stage, which can last from four to 12 months; and the thawing or recovery stage, which can take six months to two years.

“There was an instance where a patient seemed to be experiencing a frozen shoulder but it turned out to be cancer. This reinforces the importance of getting it diagnosed and treated early to minimise its effects,” Suresh said.

“Another risk factor is immobility. A minor injury to the wrist or elbow can indirectly lead to a frozen shoulder due to a lack of movement. It is common for those who have had their arms in slings or casts for prolonged periods to develop this condition.”

Suresh stressed the importance of early diagnosis and intervention to prevent long-term stiffness and immobility.

“Early diagnosis can significantly shorten the duration and severity of a frozen shoulder. Although most people will eventually recover, early intervention can speed up the process and reduce discomfort,” he said.

Treatment is divided into three categories:

• conservative management, which includes physical therapy and pain management with anti-inflammatory medications and exercises to improve shoulder mobility;
• steroid injections to reduce inflammation and make movement easier; and
• surgery, which may be considered in rare cases if the condition persists beyond 18 months.

He said staying active could help prevent the condition, noting that it is crucial to start gentle shoulder exercises as soon as possible for those who have had an injury or surgery that immobilised their arm.

In addition, exercises like yoga and pilates, which focus on stretching and flexibility, could be highly beneficial as they encourage shoulder mobility and improve flexibility, which helps prevent stiffness that could lead to a frozen shoulder, Suresh concluded.