The rounded head of the humerus fits into a shallow socket in the scapula. Surrounding this joint is the shoulder capsule, a strong connective tissue structure that stabilizes the joint.<\/p>\n
To allow smooth and pain-free movement, the capsule is lubricated by synovial fluid, which reduces friction between the joint surfaces.<\/p>\n
What Happens in Frozen Shoulder?<\/h1>\n
In frozen shoulder:<\/p>\n
- \n
- The shoulder capsule becomes thickened and stiff<\/li>\n
- Adhesions (thick bands of tissue) form<\/li>\n
- The amount of synovial fluid decreases<\/li>\n<\/ul>\n
This leads to:<\/p>\n
- \n
- Severe shoulder pain<\/li>\n
- Significant restriction in movement<\/li>\n
- Difficulty performing daily activities<\/li>\n<\/ul>\n
Both active and passive shoulder movements become painful and restricted.<\/p>\n
Ayurvedic Perspective on Frozen Shoulder (Apabahuka)<\/h1>\n
In Ayurveda, frozen shoulder is referred to as Apabahuka<\/strong>. It primarily affects the Amsa Sandhi<\/strong> (shoulder joint) and is mainly caused by an imbalance of Vata Dosha<\/strong>.<\/p>\n
Apabahuka presents with symptoms such as:<\/p>\n
- \n
- Shoulder pain (Amsa Shoola<\/strong>)<\/li>\n
- Stiffness (Amsa Stambha<\/strong>)<\/li>\n
- Restricted shoulder movements<\/li>\n
- Weakness (Bala Kshaya<\/strong>)<\/li>\n<\/ul>\n
These symptoms closely resemble the clinical presentation of frozen shoulder.<\/p>\n
Causes According to Ayurveda<\/h2>\n
Several factors contribute to the aggravation of Vata Dosha, including:<\/p>\n
- \n
- Exposure to cold (Sheeta<\/strong>)<\/li>\n
- Improper posture or overuse of the shoulder<\/li>\n
- Aging (Vaya Vriddhi<\/strong>)<\/li>\n
- Trauma (Abhighata<\/strong>)<\/li>\n
- Chronic illnesses such as Diabetes Mellitus<\/li>\n<\/ul>\n
Ayurvedic Understanding of Disease Progression<\/h2>\n
According to Ayurveda, aggravated Vata leads to the following:<\/p>\n
- \n
- Tissue depletion (Dhatu Kshaya<\/strong>)<\/li>\n
- Blockage of body channels (Srotorodha<\/strong>)<\/li>\n
- Reduction in joint lubrication due to Shleshaka Kapha Kshaya<\/strong><\/li>\n<\/ul>\n
As a result, the shoulder becomes painful, stiff, and difficult to move.<\/p>\n
Symptoms of Frozen Shoulder<\/h1>\n
Common symptoms include:<\/p>\n
- \n
- Persistent shoulder pain<\/li>\n
- Stiffness and reduced range of motion<\/li>\n
- Difficulty performing everyday activities such as dressing or reaching overhead<\/li>\n
- Pain that worsens with shoulder movement<\/li>\n
- Inability to move the shoulder normally, even with assistance<\/li>\n<\/ul>\n
Pain is usually dull or aching in nature and is often more severe during the early stage of the condition.<\/p>\n
Stages of Frozen Shoulder<\/h1>\n
Frozen shoulder usually progresses through three stages.<\/p>\n
1. Freezing Stage<\/h2>\n
- \n
- Gradual onset of shoulder pain<\/li>\n
- Increasing stiffness and reduced movement<\/li>\n
- Pain worsens over time<\/li>\n<\/ul>\n
Duration:<\/strong> 6 weeks to 9 months<\/p>\n
2. Frozen Stage<\/h2>\n
- \n
- Pain may gradually decrease<\/li>\n
- Stiffness remains severe<\/li>\n
- Daily activities become difficult<\/li>\n<\/ul>\n
Duration:<\/strong> 4 to 6 months<\/p>\n
3. Thawing Stage<\/h2>\n
- \n
- Gradual improvement in movement<\/li>\n
- Slow return of flexibility and strength<\/li>\n<\/ul>\n
Duration:<\/strong> 6 months to 2 years<\/p>\n
Causes and Risk Factors of Frozen Shoulder<\/h1>\n
Frozen shoulder develops when the shoulder capsule becomes inflamed, thickened, and tight. Scar tissue (adhesions) may form, reducing lubrication within the joint and making movement painful and restricted.<\/p>\n
Although the exact cause is not always known, several factors increase the risk.<\/p>\n
Common Risk Factors<\/h2>\n
- \n
- Age:<\/strong> Most common between 40\u201360 years<\/li>\n
- Gender:<\/strong> More common in women<\/li>\n
- Diabetes Mellitus:<\/strong> Increased risk in diabetic patients<\/li>\n
- Injury or Surgery:<\/strong> Fractures, rotator cuff injuries, or surgery requiring prolonged immobilization<\/li>\n
- Prolonged Immobilization:<\/strong> Use of slings or reduced movement after injury<\/li>\n
- Other Medical Conditions:<\/strong>\n
- \n
- \u0642\u0635\u0648\u0631 \u0627\u0644\u063a\u062f\u0629 \u0627\u0644\u062f\u0631\u0642\u064a\u0629<\/li>\n
- Hyperthyroidism<\/li>\n
- \u0645\u0631\u0636 \u0627\u0644\u0634\u0644\u0644 \u0627\u0644\u0631\u0639\u0627\u0634<\/li>\n
- Heart disease<\/li>\n
- \u0627\u0644\u0633\u0643\u062a\u0629 \u0627\u0644\u062f\u0645\u0627\u063a\u064a\u0629<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
Diagnosis of Frozen Shoulder<\/h1>\n
Frozen shoulder is diagnosed through:<\/p>\n
- \n
- Medical history<\/li>\n
- Symptom evaluation<\/li>\n
- Physical examination<\/li>\n
- Imaging tests when necessary<\/li>\n<\/ul>\n
During the physical examination:<\/p>\n
- \n
- \n
- \n
- Active shoulder movement is assessed.<\/li>\n
- Passive shoulder movement is assessed.<\/li>\n
- Pain and stiffness are evaluated.<\/li>\n
- The affected shoulder is compared with the opposite side.<\/li>\n<\/ul>\n
A significant restriction of both active and passive movement, particularly external rotation, can support the diagnosis of frozen shoulder.<\/p>\n<\/li>\n<\/ul>\n
Imaging Tests<\/h2>\n
Imaging may be recommended when the doctor needs to rule out other causes of shoulder pain.<\/p>\n
X-Ray<\/h3>\n
Used to rule out:<\/p>\n
- \n
- \u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0645\u0641\u0627\u0635\u0644<\/li>\n
- Fractures<\/li>\n
- Bone abnormalities<\/li>\n
- Other structural changes<\/li>\n<\/ul>\n
MRI or Ultrasound<\/h3>\n
An MRI or ultrasound is not always necessary for diagnosing frozen shoulder but may be used to rule out conditions such as the following:<\/p>\n
- \n
- Rotator cuff tears<\/li>\n
- Tendon injuries<\/li>\n
- Soft-tissue abnormalities<\/li>\n
- Other causes of persistent shoulder pain<\/li>\n<\/ul>\n
<\/p>\n
Our hospital provides an integrated approach to frozen shoulder treatment, combining Ayurveda, physiotherapy, and acupuncture for comprehensive patient care.<\/strong><\/p>\n
Role of Ayurveda in Frozen Shoulder<\/h1>\n
1. Lepanam<\/h2>\n
Lepanam is an Ayurvedic external therapy in which medicated herbal paste is applied over the affected region.<\/p>\n
Procedure<\/h3>\n
- \n
- Medicated herbal paste is prepared.<\/li>\n
- The paste is evenly applied over the affected shoulder.<\/li>\n
- It is retained for a specified duration.<\/li>\n
- The paste is then gently removed.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h3>\n
- \n
- \u064a\u0642\u0644\u0644 \u0627\u0644\u0623\u0644\u0645 \u0648\u0627\u0644\u0627\u0644\u062a\u0647\u0627\u0628\u0627\u062a<\/li>\n
- Relieves stiffness and tenderness<\/li>\n
- Provides a soothing effect<\/li>\n
- Helps relax muscles and soft tissues<\/li>\n<\/ul>\n
2. Rooksha \u0643\u064a\u0632\u064a<\/a> (Podikizhi)<\/h2>\n
![\"PODIKIZHI:](\"https:\/\/mauryaayurveda.com\/wp-content\/uploads\/2025\/06\/Podikizhi-300x200.jpg\")
<\/p>\nRooksha Kizhi, also known as Podikizhi, is a dry fomentation therapy performed using heated herbal powders.<\/p>\n
Procedure<\/h3>\n
- \n
- Herbal powders are heated uniformly.<\/li>\n
- The powders are tied into cloth boluses.<\/li>\n
- Warm boluses are gently massaged over the shoulder region.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h3>\n
- \n
- Reduces stiffness and heaviness<\/li>\n
- Relieves pain and restricted movement<\/li>\n
- Improves blood circulation and shoulder mobility<\/li>\n<\/ul>\n
3. Dhanyamla Dhara<\/a><\/h2>\n
Dhanyamla Dhara is commonly used during the initial stage when pain and inflammation are more severe.<\/p>\n
Procedure<\/h3>\n
- \n
- Warm fermented herbal liquid (Dhanyamla) is prepared.<\/li>\n
- The liquid is continuously poured over the affected shoulder for a fixed duration.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h3>\n
- \n
- Reduces inflammation and swelling<\/li>\n
- Relieves pain and muscle tightness<\/li>\n
- Improves circulation and flexibility<\/li>\n<\/ul>\n
4. Ela kizhi<\/h2>\n
![\"Elakizhi-FROZEN](\"https:\/\/mauryaayurveda.com\/wp-content\/uploads\/2025\/06\/Elakizhi-300x200.jpg\")
<\/p>\nEla Kizhi is an Ayurvedic heat therapy using warm herbal leaf bundles to relieve pain, stiffness, and restricted movement in frozen shoulders.<\/p>\n
Procedure<\/h3>\n
- \n
- Herbal leaves are fried with medicinal ingredients and tied into cotton bundles.<\/li>\n
- Warm medicated oil is applied over the shoulder.<\/li>\n
- The heated herbal bundles are gently pressed and massaged over the affected area.<\/li>\n
- The bundles are reheated repeatedly to maintain warmth during the therapy.<\/li>\n
- Sessions usually last 20\u201340 minutes for several days.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h3>\n
- \n
- \u064a\u0642\u0644\u0644 \u0627\u0644\u0623\u0644\u0645 \u0648\u0627\u0644\u0627\u0644\u062a\u0647\u0627\u0628\u0627\u062a<\/li>\n
- Relieves muscle tightness and spasm<\/li>\n
- \u064a\u062d\u0633\u0646 \u0627\u0644\u062f\u0648\u0631\u0629 \u0627\u0644\u062f\u0645\u0648\u064a\u0629<\/li>\n
- Helps increase shoulder mobility<\/li>\n
- Reduces stiffness and heaviness<\/li>\n<\/ul>\n
5.\u00a0 Naranga Kizhi<\/h2>\n
Naranga Kizhi is an Ayurvedic therapy using warm lemon and herbal poultices to reduce pain and stiffness in frozen shoulders.<\/p>\n
Procedure<\/h3>\n
- \n
- Lemon pieces are mixed with herbal powders and rock salt, then tied securely in Kora cloth to prepare therapeutic boluses.<\/li>\n
- Warm herbal oil is applied over the shoulder.<\/li>\n
- The heated lemon bundles are pressed and massaged over the affected area.<\/li>\n
- The bundles are reheated regularly to maintain warmth.<\/li>\n
- Sessions usually last 20\u201330 minutes<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h3>\n
- \n
- Relaxes tight muscles<\/li>\n
- Reduces pain and stiffness<\/li>\n
- \u064a\u062d\u0633\u0646 \u0627\u0644\u062f\u0648\u0631\u0629 \u0627\u0644\u062f\u0645\u0648\u064a\u0629<\/li>\n
- Enhances flexibility and shoulder movement<\/li>\n<\/ul>\n
6. Pichu (Local Oil Application)<\/h2>\n
Pichu is a local oil retention therapy used to provide continuous soothing and nourishment to the affected joint.<\/p>\n
Procedure<\/h3>\n
- \n
- Medicated oil is warmed mildly.<\/li>\n
- Cotton or gauze soaked in medicated oil is placed over the shoulder joint.<\/li>\n
- It is retained locally for a specific duration.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h3>\n
- \n
- Reduces dryness and stiffness<\/li>\n
- Relieves pain and discomfort<\/li>\n
- Nourishes muscles and soft tissues<\/li>\n
- Helps relax the shoulder joint<\/li>\n<\/ul>\n
7. Ekanga Seka (Localized Pizhichil) with Murivenna<\/h2>\n
Ekanga Seka combines warm oil pouring over the affected area with gentle massage.<\/p>\n
Procedure<\/h3>\n
- \n
- Murivenna oil is heated to a comfortable temperature.<\/li>\n
- Warm oil is continuously poured over the shoulder region.<\/li>\n
- Gentle synchronized massage is performed during the procedure\u00a0to help relax the muscles and support local circulation.<\/li>\n
- The treatment is performed for a specified duration based on the patient\u2019s condition and individualized treatment plan.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h3>\n
- \n
- \u064a\u0642\u0644\u0644 \u0627\u0644\u0623\u0644\u0645 \u0648\u0627\u0644\u0627\u0644\u062a\u0647\u0627\u0628\u0627\u062a<\/li>\n
- Relieves stiffness and muscle spasm<\/li>\n
- Improves circulation and tissue nourishment<\/li>\n
- Enhances shoulder mobility and flexibility<\/li>\n<\/ul>\n
Physiotherapy Management For Frozen Shoulder<\/h1>\n
Physiotherapy plays an important role in reducing pain, improving movement, and restoring shoulder function. Treatment is usually planned according to the stage and severity of the condition.<\/p>\n
At our hospital, we provide a structured physiotherapy-based rehabilitation program designed to reduce pain, improve mobility, and restore normal shoulder function.<\/p>\n
1. Pain Reduction Techniques<\/h2>\n
Pain reduction is the initial goal of treatment because severe pain limits shoulder movement and daily activities.<\/p>\n
1.1 Heat Therapy (Hot Packs)<\/h3>\n
Procedure<\/h4>\n
- \n
- Hot packs are applied over the shoulder region for approximately 15\u201320 minutes.<\/li>\n
- The heat penetrates the soft tissues and helps relax tight muscles.<\/li>\n
- It is usually given before exercises or stretching sessions.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Relaxes muscle spasm and tightness<\/li>\n
- Improves local blood circulation<\/li>\n
- Reduces pain and discomfort<\/li>\n
- Prepares the shoulder for exercise and mobilization<\/li>\n<\/ul>\n
1.2 Ultrasound Therapy<\/h3>\n
Procedure<\/h4>\n
- \n
- Therapeutic ultrasound uses sound waves delivered through a handheld probe.<\/li>\n
- Gel is applied to the skin to allow smooth transmission of waves.<\/li>\n
- The therapist moves the probe gently around the painful shoulder area.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Reduces inflammation<\/li>\n
- Helps decrease pain<\/li>\n
- Promotes tissue healing<\/li>\n
- Improves flexibility of soft tissues<\/li>\n<\/ul>\n
1.3 Manual Therapy<\/h3>\n
![\"SHOULDER](\"https:\/\/mauryaayurveda.com\/wp-content\/uploads\/2026\/08\/ChatGPT-Image-Aug-15-2026-10_18_05-AM-300x240.png\")
<\/p>\nProcedure<\/h4>\n
- \n
- The physiotherapist performs gentle mobilization techniques on the shoulder joint.<\/li>\n
- Different grades of mobilization may be used depending on pain and stiffness.<\/li>\n
- Soft tissue release techniques may also be performed.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Reduces joint stiffness<\/li>\n
- Improves joint mobility<\/li>\n
- Helps reduce pain<\/li>\n
- Enhances shoulder movement<\/li>\n<\/ul>\n
2. Range of Motion (ROM) Exercises<\/h2>\n
ROM exercises are important to prevent worsening of stiffness and gradually restore normal shoulder movement.<\/p>\n
2.1 Passive Movements<\/h3>\n
Procedure<\/h4>\n
- \n
- The therapist gently moves the patient\u2019s shoulder without active effort from the patient.<\/li>\n
- Movements are performed within the pain-free range.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Prevents joint stiffness<\/li>\n
- Maintains joint mobility<\/li>\n
- Reduces muscle tightness<\/li>\n<\/ul>\n
2.2 Active-Assisted Movements<\/h3>\n
Procedure<\/h4>\n
- \n
- The patient performs shoulder movements with assistance.<\/li>\n
- Support may be provided by the therapist, the opposite hand, or exercise equipment.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Encourages gradual muscle activation<\/li>\n
- Improves movement confidence<\/li>\n
- Enhances flexibility and coordination<\/li>\n<\/ul>\n
2.3 Pendulum Exercise<\/h3>\n
![\"PENDULUM](\"https:\/\/mauryaayurveda.com\/wp-content\/uploads\/2026\/08\/ChatGPT-Image-Aug-15-2026-10_12_04-AM-300x240.png\")
<\/p>\nProcedure<\/h4>\n
- \n
- The patient bends slightly forward while supporting the body with the unaffected arm.<\/li>\n
- The affected arm hangs freely.<\/li>\n
- Gentle circular or swinging movements are performed.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Reduces pain and stiffness<\/li>\n
- Promotes gentle shoulder mobility<\/li>\n
- Helps relax shoulder muscles<\/li>\n<\/ul>\n
2.4 Finger Walk Exercise<\/h3>\n
Procedure<\/h4>\n
- \n
- The patient stands facing a wall.<\/li>\n
- Fingers are slowly \u201cwalked\u201d up the wall as high as comfortable.<\/li>\n
- The arm is gradually lowered back down.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Improves shoulder elevation<\/li>\n
- Increases range of motion<\/li>\n
- Enhances flexibility and function<\/li>\n<\/ul>\n
2.5 Active Exercises<\/h3>\n
Procedure<\/h4>\n
- \n
- The patient independently performs shoulder movements.<\/li>\n
- Exercises include shoulder flexion, abduction, rotation, and elevation.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Improves muscle control<\/li>\n
- Restores functional movement<\/li>\n
- Increases joint mobility<\/li>\n<\/ul>\n
3. Stretching Exercises<\/h2>\n
Stretching exercises help improve flexibility and reduce capsular tightness.<\/p>\n
3.1 External Rotation Stretching<\/h3>\n
Purpose<\/h4>\n
Improves outward rotation of the shoulder.<\/p>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Reduces stiffness<\/li>\n
- Improves ability to perform grooming and dressing activities<\/li>\n<\/ul>\n
3.2 Forward Elevation Stretching<\/h3>\n
Purpose<\/h4>\n
Improves the ability to raise the arm overhead.<\/p>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Helps in reaching activities<\/li>\n
- Increases shoulder flexibility<\/li>\n<\/ul>\n
3.3 Cross-Body Stretching<\/h3>\n
Purpose<\/h4>\n
Improves movement across the chest.<\/p>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Enhances shoulder flexibility<\/li>\n
- Reduces tightness around the posterior shoulder<\/li>\n<\/ul>\n
4. Strengthening Exercises<\/h2>\n
Strengthening exercises are introduced after pain decreases and movement improves.<\/p>\n
4.1 Rotator Cuff Strengthening<\/h3>\n
Purpose<\/h4>\n
Strengthens the muscles that stabilize the shoulder joint.<\/p>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Improves shoulder stability<\/li>\n
- Prevents weakness and recurrence<\/li>\n<\/ul>\n
4.2 Resistance Band Exercises<\/h3>\n
Procedure<\/h4>\n
- \n
- Elastic resistance bands are used for shoulder movements.<\/li>\n
- Resistance is gradually increased according to patient tolerance.<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Improves muscle strength<\/li>\n
- Enhances endurance and coordination<\/li>\n<\/ul>\n
4.3 Functional Training<\/h3>\n
Purpose<\/h4>\n
Restores the ability to perform daily activities.<\/p>\n
Activities<\/h4>\n
- \n
- Reaching overhead<\/li>\n
- Lifting light objects<\/li>\n
- Dressing and grooming tasks<\/li>\n<\/ul>\n
\u0641\u0648\u0627\u0626\u062f<\/h4>\n
- \n
- Improves independence<\/li>\n
- Restores normal shoulder function<\/li>\n<\/ul>\n
Acupuncture for Frozen Shoulder<\/h1>\n
Acupuncture is used as a supportive treatment to help reduce symptoms and improve shoulder function.<\/p>\n
Effects of Acupuncture<\/h2>\n
- \n
- Helps relieve shoulder pain<\/li>\n
- Improves blood circulation to the affected area<\/li>\n
- Relaxes tight muscles around the shoulder<\/li>\n
- Reduces inflammation in the joint<\/li>\n
- Supports gradual improvement in shoulder movement<\/li>\n<\/ul>\n
Procedure<\/h2>\n
Fine, sterile needles are carefully inserted into specific acupuncture points by a trained practitioner. The treatment is designed to help relieve pain, reduce muscle tension, and support improved shoulder mobility.<\/p>\n
Early diagnosis and a combination of physiotherapy, Ayurvedic therapies, exercise rehabilitation, and supportive treatments can significantly improve pain, mobility, and overall quality of life in individuals with frozen shoulder.<\/strong><\/p>\n
Our treatment is focused on reducing pain, improving mobility, and restoring normal shoulder function safely and effectively, helping patients return to their daily activities with greater comfort and confidence.<\/strong><\/p>\n
<\/p>\n
<\/p>\n
DISCLAIMER: The information provided in this article is intended solely for educational purposes. Treatment decisions should be made exclusively by a well-qualified Ayurvedic physician. Self-medication is strongly discouraged.<\/strong><\/p>\n
Maurya Ayurveda Hospital, opposite to Sabine Hospital, Pezhakkapilly P.O, Muvattupuzha, Ernakulam; PIN: 686673, Contact no.: 9947183000<\/p>\n
- \n
- Gender:<\/strong> More common in women<\/li>\n
- Age:<\/strong> Most common between 40\u201360 years<\/li>\n
- Blockage of body channels (Srotorodha<\/strong>)<\/li>\n
- Stiffness (Amsa Stambha<\/strong>)<\/li>\n
- Shoulder pain (Amsa Shoola<\/strong>)<\/li>\n