Demographic and Clinical Characteristics of Primary Frozen Shoulder in a Korean Population: A Retrospective Analysis of 1,373 Cases

Cho, Chul-Hyun;Koo, Tae Won;Cho, Nam-Su;Park, Kyoung-Jin;Lee, Bong Gun;Shin, Dongju;Choi, Sungwook;Cho, Seung-Hyun;Kim, Myung-Sun;Ko, Sang-Hun;Kim, Chul-Hong;Park, Jin-Young;Yoo, Yon-Sik

  • Received : 2015.01.26
  • Accepted : 2015.04.28
  • Published : 2015.09.30


Background: The aim of this study was to investigate the demographic and clinical characteristics of patients with primary frozen shoulder in a Korean population. Methods: A total of 1,373 patients whose shoulders were diagnosed with primary frozen shoulder across 11 resident-training hospitals were reviewed retrospectively. Various demographic characteristics and clinical characteristics according to gender and presence of diabetes were evaluated. Results: The average age of patients was 55.4 years. Gender proportion was 58.3% females and 41.7% males. The frozen shoulder involved the non-dominant arm in 60.7% of patients and the bilateral arms in 17.6% of patients. The average duration of symptoms was 8.9 months, and 51.3% of patients had experienced nocturnal pain. Comorbidities associated with frozen shoulder in our sample of patients included diabetes (18.7%), cardiovascular diseases (17.7%), thyroid diseases (5.4%), and cerebrovascular diseases (3.6%). The diabetic group was correlated with the following demographic and clinical characteristics: old age, involvement of the dominant arm, nocturnal pain, long duration of symptoms, and no history of trauma. Further, we found that, in males, having a frozen shoulder was significantly correlated with a history of trauma; in females, having a frozen shoulder was significantly correlated with having thyroid diseases. Conclusions: These demographic data of primary frozen shoulder in the Korean population were consistent with those of previously reported epidemiologic studies. Primary frozen shoulder with diabetes was correlated with old age, bilateral involvement, long duration of symptoms, and nocturnal pain.


Frozen shoulder;Primary;Risk factors;Diabetes mellitus


  1. Korean Shoulder and Elbow Society. The shoulder and elbow. 1st ed. Seoul: Young Chang Medical Book; 2007. 289-98.
  2. Neviaser JS. Adhesive capsulitis of the shoulder: a study of the pathological findings in periarthritis of the shoulder. J Bone Joint Surg Am. 1945;27(2):211-22.
  3. Sheridan MA, Hannafin JA. Upper extremity: emphasis on frozen shoulder. Orthop Clin North Am. 2006;37(4):531-9.
  4. Endres NK, ElHanssan B, Higgins LD, Warner JJ. The stiff shoulder. In: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW, eds. The shoulder. 4th ed. Philadelphia: Saunders; 2008. 1405-35.
  5. Pillai G, Cuomo F. Classification, evaluation and nonoperative treatment of frozen shoulder. In: Zuckerman JD, Iannotti JP, Miniaci A, Williams GR, eds. Disorders of the shoulder: diagnosis and management. 3rd ed. New York: Lippincott Williams & Willkins; 2014. 203-10.
  6. Nam KY, Moon YL, Kim DH. Bursoscopic finding in primary adhesive capsulitis of the shoulder. J Korean Shoulder Elbow Soc. 2008;11(1):19-23.
  7. Cho CH, Jung SW, Son ES, Hwang IS. Sleep status and quality of life in patients with frozen shoulder. J Korean Orthop Assoc. 2012;47(3):205-10.
  8. Binder AI, Bulgen DY, Hazleman BL, Roberts S. Frozen shoulder: a long-term prospective study. Ann Rheum Dis. 1984; 43(3):361-4.
  9. Bridgman JF. Periarthritis of the shoulder and diabetes mellitus. Ann Rheum Dis. 1972;31(1):69-71.
  10. Hand C, Clipsham K, Rees JL, Carr AJ. Long-term outcome of frozen shoulder. J Shoulder Elbow Surg. 2008;17(2):231-6.
  11. Lundberg BJ. The frozen shoulder. Clinical and radiographical observations. The effect of manipulation under general anesthesia. Structure and glycosaminoglycan content of the joint capsule. Local bone metabolism. Acta Orthop Scand Suppl. 1969;119:1-59.
  12. van der Windt DA, Koes BW, de Jong BA, Bouter LM. Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis. 1995;54(12):959-
  13. Guyver PM, Bruce DJ, Rees JL. Frozen shoulder: a stiff problem that requires a flexible approach. Maturitas. 2014;78(1):11-6.
  14. Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA. Current review of adhesive capsulitis. J Shoulder Elbow Surg. 2011; 20(3):502-14.
  15. Robinson CM, Seah KT, Chee YH, Hindle P, Murray IR. Frozen shoulder. J Bone Joint Surg Br. 2012;94(1):1-9.
  16. Shah N, Lewis M. Shoulder adhesive capsulitis: systematic review of randomised trials using multiple corticosteroid injections. Br J Gen Pract. 2007;57(541):662-7.
  17. Shaffer B, Tibone JE, Kerlan RK. Frozen shoulder. A long-term follow-up. J Bone Joint Surg Am. 1992;74(5):738-46.
  18. Li W, Lu N, Xu H, Wang H, Huang J. Case control study of risk factors for frozen shoulder in China. Int J Rheum Dis. 2015; 18(5):508-13.
  19. Wang K, Ho V, Hunter-Smith DJ, Beh PS, Smith KM, Weber AB. Risk factors in idiopathic adhesive capsulitis: a case control study. J Shoulder Elbow Surg. 2013;22(7):e24-9.


Supported by : National Research Foundation of Korea (NRF)