Introduction

“I can’t lift my arm.”

“My shoulder hurts so much I can’t sleep at night.”

If these sound familiar, you may be suffering from frozen shoulder (adhesive capsulitis).

Though many believe it will heal naturally, some cases last for years and leave behind lasting stiffness if not treated properly.

In this blog, we’ll explore the causes, stages, and how osteopathic treatment can help, based on up-to-date medical research including sources from PubMed.

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1. Causes of Frozen Shoulder

Frozen shoulder is broadly categorized into two types:

● Primary (Idiopathic)

• Occurs without any obvious trauma or surgery.
• Thought to stem from chronic inflammation, fibrosis, and tightening of the joint capsule.
• Tends to affect the non-dominant arm, though the exact mechanism is not yet clear (PubMed).

● Secondary

• Triggered by trauma, surgery, or long-term immobilization.
• Common after fractures or post-operative recovery periods.
• Often associated with other shoulder conditions like rotator cuff tears or bursitis (PubMed).

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Systemic Risk Factors

Recent research shows several underlying health conditions increase the risk of developing frozen shoulder:

1. Diabetes (Type 1 & 2) – significantly higher risk (10–20% in general population).
2. Thyroid dysfunction – both hyper- and hypothyroidism, especially in older women.
3. Cerebrovascular disease (e.g., stroke) – often leads to contractures on the affected side.
4. Cardiovascular diseases – such as coronary artery disease.
5. Autoimmune and collagen disorders.
6. Dupuytren’s contracture – often co-occurs with frozen shoulder (PMC).

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2. Stages of Frozen Shoulder

Frozen shoulder typically progresses through three clinical stages:

● Acute (Inflammatory) Stage

• Duration: Several weeks to a few months
• Severe pain even at rest, especially at night

● Freezing (Stiffness) Stage

• Duration: Around 6 months
• Pain subsides, but shoulder movement becomes highly restricted

● Thawing (Recovery) Stage

• Duration: 6–12 months
• Gradual return of shoulder range and function

Note: Though it may resolve naturally within 1–2 years, some cases last over 3 years. Early intervention can prevent permanent loss of motion.

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3. What Osteopathy Can Do

Effective treatment depends on the current stage of frozen shoulder. Osteopathic care focuses on three main strategies:

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① Structural Adjustment

• During the painful acute stage, we avoid manipulating the shoulder directly.
• Instead, we improve mobility in the thoracic spine, rib cage, and pelvis, which reduces strain on the shoulder.
• This helps maintain functional movement patterns while the shoulder heals.

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② Improving Circulation

• Good blood and lymph flow are vital to resolve inflammation.
• Proper circulation supports immune response, nutrient delivery, and waste clearance.
• Osteopathy helps open up the circulatory pathways and speeds up recovery.

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③ Autonomic Nervous System Balance

• Chronic pain leads to sympathetic nervous system overactivation – causing tension, poor sleep, and slower healing.
• Techniques that stimulate the parasympathetic system (relaxation mode) can improve tissue repair.
• Breathing work and cranial or visceral techniques also aid recovery.

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After the Acute Stage

Once inflammation settles, direct work on the shoulder becomes essential:

• We gently release the teres minor, infraspinatus, teres major, and ligaments like the coracohumeral ligament.
• This minimizes long-term stiffness and restores smooth joint movement.
• We also teach postural corrections, exercise habits, and anti-inflammatory lifestyle strategies to prevent recurrence.

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In Conclusion

Frozen shoulder should not be dismissed as something that will “just go away.”

With proper osteopathic care, you can shorten recovery time, reduce pain, and prevent long-term stiffness.

At our clinic, we focus on whole-body assessment and individualized care that supports your natural healing abilities.

If shoulder pain is interfering with your life, feel free to reach out—we’re here to help you move freely again.

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#Kyoto #KyotoOsteopathyCenter #Osteopathy #Chiropractic #Pain

#Numbness #Paralysis #Posture #Walking #FrozenShoulder #AdhesiveCapsulitis #ShoulderPain #NightPain

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For Those in Japan with Physical Discomfort

Are you unsure where to get care for pain or tension?
Worried about language barriers?

We offer gentle, hands-on osteopathy to support your body’s natural healing.

– Neck/shoulder stiffness from desk work

– Back pain or leg fatigue after travel

– Shin splints from walking/running

– Numbness in arms or legs

🤝 Still Learning English, but Here to Help
I’m still learning English,
but I study every day to support visitors and residents in Japan.

My English isn’t perfect, but I’ll listen carefully and respond with care.
I often use Google Translate—please don’t hesitate to contact me.

Sota Omura,
Qualifications: Licensed Physical Therapist / Master of Health Science

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