Symptoms of Shoulder Periarthritis

At the onset of adhesive capsulitis (frozen shoulder), patients typically experience intermittent shoulder pain, most commonly developing insidiously and chronically. As the condition progresses, 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.

A sudden impact or traction on the shoulder may provoke 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 tend to be especially sensitive to weather changes.

Range of motion (ROM) in the shoulder joint becomes restricted in all directions, most notably in abduction, elevation, and internal and external rotation. As the disease advances, adhesions develop within the glenohumeral capsule and surrounding soft tissues, leading to progressive muscular weakness. Additional contributing factors—including shortening and tightening of the coracohumeral ligament in internal rotation—further restrict both active and passive shoulder movement in all planes. Common activities such as combing hair, dressing, washing the face, and placing hands on the waist become increasingly difficult or impossible. 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.