Aetiology and associations

Aetiology of the condition remain unclear

Frozen shoulder may also be associated with another systemic illness (1)

• diabetes mellitus
  • most common association of a secondary frozen shoulder
  • incidence of frozen shoulder in diabetes patients is reported to be 10%-36% (incidence in type 1 and type 2 diabetes is similar)
  • frozen shoulder in diabetes is often more severe and is more resistant to treatment
  • recurrence risk is also higher
• Dupuytren's disease
• rarely a frozen shoulder may be associated with conditions such as
  • hyperthyroidism, hypothyroidism, and hypoadrenalism
  • Parkinson's disease
  • cardiac disease
  • pulmonary disease
  • stroke
    • in the case of stroke, shoulder stiffness may be the result of muscle spasticity in the shoulder region
• the development of a frozen shoulder has also been reported subsequent to non-shoulder surgical procedures, such as cardiac surgery, cardiac catheterisation through the brachial artery, neurosurgery, and radical neck dissection (1,2)

Reference:

• (1) Dias R et al. Frozen shoulder. BMJ 2005; 331:1453-1456.
• (2) van de Laar SM, van der Zwaal P. Management of frozen shoulder Orthopedic Research and Reviews 2014;6:81-90