What Exactly is "Frozen / Fifty Shoulder"? Is It Just a Part of Getting Old?

Written By：C.M.P. Melody 林医师

In Malaysia, we often hear the term "Fifty Shoulder." If you’re in your 40s or 50s and your shoulder starts to hurt or you can't lift your arm, you might think you have it. But is it really as simple as just "getting old"?

The answer is: not at all!

The term "Fifty Shoulder" is its common name, but its medical name is Adhesive Capsulitis, also known as Frozen Shoulder. As the name suggests, it feels like your shoulder is "frozen" in place—it's painful, stiff, and you can barely move it.

Why Does It "Freeze"?

Your shoulder is a very flexible joint. It's covered by a thin layer, like a "jacket," called the joint capsule. When this "jacket" becomes inflamed, it gets thick and hard, and can even stick together. This "glues" the entire shoulder joint, making it impossible to lift your arm without pain.

The Three Stages of Frozen Shoulder:

This condition doesn't happen suddenly; it gradually gets worse and then slowly gets better. It typically goes through three distinct stages:

1️⃣ The "Freezing" Stage (Painful Phase)

🔹Symptoms: Your shoulder is very painful, especially at night, which can make it hard to sleep or lie on that side.

🔹Duration: About 1.5 to 9 months.

🔹Feeling: Like your shoulder is just starting to "freeze," with a sharp, piercing pain.

2️⃣ The "Frozen" Stage (Stiff Phase)

🔹Symptoms: The pain may not be as severe, but your shoulder becomes extremely stiff. It's very difficult to lift your arm, making simple tasks like combing your hair, getting dressed, or reaching for high objects a struggle.

🔹Duration: About 4 to 6 months.

🔹Feeling: Your shoulder is completely "frozen solid."

3️⃣ The "Thawing" Stage (Recovery Phase)

🔹Symptoms: The pain gradually lessens, and your shoulder slowly begins to "thaw." Your range of motion gradually improves.

🔹Duration: It may take six months to two years, or even longer.

🔹Feeling: The ice is melting, and your shoulder is slowly regaining its flexibility.

The entire process, from the initial pain to full recovery, can take anywhere from one to three years or more.

Why Do People Get It? Is It Really Because of Age?

"Fifty Shoulder" gets its name because it most commonly affects people between the ages of 40 and 60. However, it is not a condition you are guaranteed to get just because you're aging! Many factors can contribute to it:

➡️ Unknown Causes: 

Most cases of frozen shoulder have no clear cause. However, it may be linked to an inflammatory response in the body, hormonal imbalances (for example, people with diabetes and thyroid issues are more susceptible and may have a more severe and longer-lasting case), or an issue with the immune system.

➡️ Specific Causes:

🔸 Shoulder Injury or Surgery: 

If you've had a shoulder injury (like a fall or fracture) or surgery, fear of pain might cause you to avoid moving the joint. Over time, this inactivity can cause the joint to stiffen up.

🔸Conditions like Stroke or Heart Disease: 

Certain conditions can lead to reduced activity or nervous system issues, which can indirectly lead to a frozen shoulder.

🔸Prolonged Inactivity: 

If your arm is in a cast for a long time or you are bedridden, the shoulder's long-term inactivity can also cause it to "freeze."

🔸Poor Posture or Overuse: 

Chronic strain and inflammation from long-term slouching, incorrect posture at a computer, or repetitive shoulder movements (in certain sports or jobs) can be contributing factors.

🔸TCM Perspective (Wind and Cold): 

From a TCM perspective, if your body is weak (deficient in qi and blood) and invaded by "pathogenic factors" like wind, cold, and dampness (for example, from being in an air-conditioned room or getting wet in the rain), it can block your meridians and impede circulation. This can lead to the joint becoming "stuck" over time.

"Fifty Shoulder" is not an inevitable part of aging; it's an issue of joint inflammation and stiffness. While it is more common in middle-aged individuals, it can be caused by various complex factors, including inflammation, hormonal and immune issues, and poor circulation.

If you or a family member notices shoulder pain or an inability to lift your arm, do not just endure it or assume it's "just aging."

The earlier you get it checked out by a doctor, TCM Practitioner or Physiotherapist, the better the outcome and the shorter the recovery time!

If you'd like to learn more about TCM wellness, or want a more professional recommendation tailored to your specific situation, we recommend booking a consultation.