What Causes Shoulder Periarthritis?

Chronic overuse injury is the most common cause of adhesive capsulitis (frozen shoulder). Prolonged physical labor inevitably involves frequent use of the shoulders. In particular, the soft tissues surrounding the glenohumeral joint are relatively weak and thus prone to overuse injuries.

When overuse injury occurs in the glenohumeral joint, surrounding muscles, tendons, ligaments, and fascia may become congested and exudative, leading to aseptic inflammation of the periaricular tissues and consequent restriction of shoulder joint mobility. Occasionally, even minor strains—when left untreated or inadequately managed—can accumulate over time and ultimately progress to adhesive capsulitis.

As we age, physiological functions throughout the body gradually decline. Combined with prolonged physical inactivity, this significantly increases the risk of developing adhesive capsulitis in later life. Moreover, adhesive capsulitis occurs more frequently during winter and early spring, suggesting a close association between ambient temperature changes and disease onset. Cold exposure to the shoulder joint can slow local blood flow and induce muscle spasm in the surrounding tissues, resulting in pain and restricted movement.

Certain systemic diseases are also associated with the development of adhesive capsulitis. For example, disorders affecting the heart, lungs, or biliary tract may produce referred shoulder pain. If these underlying conditions remain chronic and unresolved, the shoulder musculature may persist in a state of spasm and ischemia, eventually evolving into adhesive capsulitis.