Adhesive capsulitis, commonly known as frozen shoulder, is a condition where the shoulder joint capsule stiffens and becomes painful, limiting movement. There are two main types: primary and secondary adhesive capsulitis. Understanding the difference can help guide treatment and recovery.
At Alton Pain Clinic, we provide ultrasound-guided cortisone injections & hydrodilatation to manage both types of adhesive capsulitis and improve shoulder function.
What Is Primary Adhesive Capsulitis?
Primary adhesive capsulitis occurs spontaneously, without any obvious trigger or injury.
Signs and features include:
- Gradual onset of shoulder pain, often worsening at night
- Increasing stiffness and limited range of motion
- Typically affects one shoulder
- Most common in adults aged 40–60 years
- More likely in patients with diabetes or thyroid disorders
The exact cause is unknown, but it involves inflammation and tightening of the shoulder joint capsule.
Treatment options include:
- Ultrasound-guided cortisone injections to reduce pain and inflammation
- Ultrasound-guided hydrodilatation to improve stiffness
What Is Secondary Adhesive Capsulitis?
Secondary adhesive capsulitis develops after a specific event, such as a shoulder injury, surgery, or prolonged immobilisation.
Common triggers:
- Shoulder trauma (e.g., rotator cuff tear, fracture)
- Post-surgical immobilisation
- Long periods of inactivity due to illness or injury
Key characteristics:
- Pain and stiffness appear after the known event
- Usually affects the same shoulder that was injured or immobilised
- May develop faster than primary adhesive capsulitis
Treatment focuses on:
- Addressing the underlying cause
- Ultrasound-guided cortisone injections for pain relief
- Hydrodilatation to stretch the joint capsule if stiffness is severe
Primary vs Secondary Adhesive Capsulitis: Quick Comparison
| Feature | Primary Adhesive Capsulitis | Secondary Adhesive Capsulitis |
|---|---|---|
| Cause | Spontaneous | Triggered by injury, surgery, or immobilisation |
| Onset | Gradual | After a known event |
| Risk Factors | Diabetes, thyroid disorder, age 40–60 | Shoulder injury, surgery, prolonged immobilisation |
| Shoulder Affected | Usually one | Often the injured shoulder |
| Treatment | Cortisone injections, hydrodilatation | Treat underlying cause + injections, hydrodilatation |
When to Seek Treatment
Both primary and secondary adhesive capsulitis can significantly affect daily activities, including dressing, driving, or reaching overhead. Early assessment and treatment can:
- Reduce pain, especially night pain
- Improve shoulder range of motion
- Shorten overall recovery time
At Alton Pain Clinic, our clinicians provide personalised care plans, including ultrasound-guided injections and hydrodilatation, to ensure optimal results for every patient.
Key Takeaway
Primary adhesive capsulitis develops spontaneously and is often linked to systemic risk factors like diabetes or thyroid disorders. Secondary adhesive capsulitis occurs after injury, surgery, or prolonged immobilisation. Both types benefit from early intervention, including ultrasound-guided cortisone injections and hydrodilatation to restore movement and reduce pain.
Frequently Asked Questions
What is primary adhesive capsulitis?
Primary adhesive capsulitis, or frozen shoulder, develops spontaneously without any known cause and is often linked to diabetes, thyroid disorders, or age 40–60.
What is secondary adhesive capsulitis?
Secondary adhesive capsulitis occurs after a shoulder injury, surgery, or prolonged immobilisation, affecting the same shoulder that was injured or operated on.
How do primary and secondary frozen shoulder differ?
Primary develops gradually without a trigger, while secondary occurs after a known event like injury or surgery. Both cause pain, stiffness, and reduced range of motion.
When should I seek treatment for frozen shoulder?
If pain or stiffness limits daily activities, affects sleep, or persists beyond a few weeks, early assessment at a clinic like Alton Pain Clinic is recommended.