Symptoms of Shoulder Periarthritis

At the onset of adhesive capsulitis (frozen shoulder), the shoulder experiences intermittent pain, most commonly developing insidiously and chronically. Over time, the pain gradually intensifies, becoming persistent and dull—or even sharp and knife-like. Pain often worsens with changes in weather or physical exertion and may radiate to the neck, upper limb, and particularly the elbow.

Even minor trauma—such as accidental bumping or pulling of the shoulder—can trigger severe, tearing-like pain. A hallmark feature of this condition is diurnal variation in pain intensity: milder during the day but significantly worse at night. In cases where cold exposure triggers adhesive capsulitis, patients exhibit heightened sensitivity to weather changes.

Motion in all directions at the glenohumeral joint becomes progressively restricted, with external rotation, forward elevation, and internal/external rotation most prominently affected. As the disease advances, fibrotic adhesions develop within the joint capsule and surrounding periscapular soft tissues; concomitant muscle weakness ensues. Additional contributing factors—including shortening and tightening of the coracohumeral ligament, which fixes the shoulder in an internally rotated position—further limit both active and passive range of motion in all planes. Activities of daily living—such as combing hair, dressing, washing the face, or placing hands on the waist—become increasingly difficult. In severe cases, elbow function may also be compromised: patients cannot touch the ipsilateral shoulder with the hand while flexing the elbow, and especially cannot perform elbow flexion when the arm is extended posteriorly.