Frozen Shoulder: It’s Not Just a Stiff Joint — Muscles Matter Too Frozen shoulder is a very common yet frustrating condition. Patients often say, “My shoulder feels stuck, ” or “I can’t lift my arm even to comb my hair.” Medically, this condition is called adhesive capsulitis, but understanding frozen shoulder only as a joint problem is incomplete. What Exactly Is Frozen Shoulder? Frozen shoulder develops when the capsule of the shoulder joint becomes inflamed, thickened, and tight. This leads to: • Pain, especially at night • Gradual stiffness • Difficulty lifting or rotating the arm It usually progresses in stages — painful phase, stiff phase, and recovery phase — and can last for months or even years if not treated properly. Frozen Shoulder Is NOT Just Adhesive Capsulitis A common myth is that frozen shoulder is only due to tightening of the joint capsule. In reality, shoulder muscles play an equally important role. When pain persists: • Muscles around the shoulder go into protective spasm • Trigger points develop in rotator cuff and shoulder girdle muscles • These tight muscles further restrict movement and worsen pain This is why many patients do not improve with medicines, exercises, or physiotherapy alone. Why Scans May Look “Normal” X-rays are often normal in frozen shoulder. MRI may show capsular thickening, but muscle-related pain and dysfunction do not always appear clearly on scans. This muscular component is frequently missed — leading to prolonged suffering. Advanced Non-Surgical Treatment That Really Works Modern pain management focuses on treating both the joint and the muscles. 1. Ultrasound-Guided Dry Needling Ultrasound-guided dry needling targets tight and painful shoulder muscles with precision. Benefits include: • Immediate muscle relaxation • Reduction in deep-seated pain • Improved shoulder movement • Faster functional recovery This technique directly addresses the muscular component that is often ignored. 2. Shoulder Hydrodilatation Shoulder hydrodilatation involves gently expanding the tight joint capsule under imaging guidance. It helps by: • Reducing capsular stiffness • Improving range of motion • Enhancing the effect of physiotherapy and exercises Why Surgery Is Rarely Needed Most frozen shoulder patients do not need surgery. When treated early and correctly with a combination of ultrasound-guided dry needling and hydrodilatation, recovery is faster, safer, and long-lasting. Expert Shoulder Pain Care in Pune Dr Priya Rathi is known as one of the best shoulder pain specialists in Pune, with a strong focus on non-surgical management. Her approach goes beyond labels like “adhesive capsulitis” and treats the real pain generators — muscles, joint capsule, and nerves — using advanced ultrasound-guided techniques. Take-Home Message Frozen shoulder is not just a joint problem. Muscles are equally involved, and unless they are treated, recovery remains incomplete. If shoulder pain and stiffness are limiting your daily life, early expert intervention can prevent months of disability — without surgery.