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 shoulder. Particularly, the soft tissues surrounding the glenohumeral joint are relatively weak and thus prone to overuse injury. When such injury occurs, the surrounding muscles, tendons, ligaments, and fascia may become congested and exudative, leading to aseptic inflammation of the periaricular shoulder tissues—ultimately resulting in restricted shoulder joint mobility. Moreover, even minor strains, if not promptly and effectively treated, can accumulate over time and eventually progress to adhesive capsulitis.

As we age, physiological functions throughout the body gradually decline. Combined with prolonged physical inactivity, individuals with these risk factors are highly susceptible to developing adhesive capsulitis later in life. Furthermore, adhesive capsulitis occurs more frequently during winter and spring, suggesting a close association between ambient temperature changes and disease onset. Cold exposure to the shoulder joint may slow local blood flow and induce muscle spasm in the surrounding tissues, thereby causing pain and limiting joint mobility. Additionally, certain systemic diseases have been linked to the development of adhesive capsulitis. For instance, disorders affecting the heart, lungs, or biliary tract may produce referred pain to the shoulder region. If these primary conditions remain untreated for extended periods, the shoulder muscles may persistently remain in a state of spasm and ischemia—eventually evolving into adhesive capsulitis.