Living with a frozen shoulder: a phenomenological inquiry

Key points

1. 01Pain, not restricted movement, was the dominant and most distressing feature for all participants
2. 02Two participants reported contemplating suicide as a way to escape unrelenting pain
3. 03Loss of independence in dressing, driving, and personal hygiene led to social withdrawal and an altered sense of self
4. 04Healthcare providers frequently failed to recognise the condition or acknowledge its psychological and functional severity
5. 05When a clinician did understand and validate the diagnosis, patients described immediate emotional relief and renewed hope

How it was conducted

Design

Qualitative study using a phenomenological approach (Husserl philosophy, Colaizzi method)

Participants

10 adults (8 female, 2 male; age range 32 to 72) with a rheumatologist-confirmed diagnosis of frozen shoulder, selected by purposive sampling for significant psychosocial impact

Setting

Southern Adelaide Local Health Network rheumatology outpatient clinic, South Australia

Data collection

In-depth semi-structured interviews conducted June to August 2020, in person or via audio/video telehealth, continued until thematic saturation

Analysis

Iterative coding in NVivo 12; all interviews dual-coded by three rheumatologist authors; themes derived inductively from the data

Disease status at interview

9 of 10 participants had recovered from frozen shoulder within the preceding 2 years; 1 was still in the resolution phase

What they found

• Five main themes identified: severity of the pain experience, loss of independence, altered sense of self, significant psychological impact, and variable experience with healthcare providers
• Pain was described as severe, unpredictable, and often precipitated by movement; participants used words such as horrible, excruciating, debilitating, and unbearable
• Pain affected all facets of life including work, sleep, personal hygiene, interpersonal relationships, and independence; pain relief was the single top priority, valued above restoration of movement
• Loss of independence affected dressing, driving, shopping, and personal hygiene; those with dominant arm involvement experienced the greatest disability, occasionally with resultant loss of income
• Psychological impacts included anxiety, irritability, depression, and suicidal ideation; two participants explicitly reported contemplating suicide to end their pain
• A lack of recognition of mental health issues by treating professionals was reported and may have contributed to poorly managed psychological sequelae
• Many participants saw 3 or 4 general practitioners before receiving a correct diagnosis; healthcare providers sometimes dismissed patient-reported symptoms or misdiagnosed as bursitis
• Participants whose clinician confidently identified and managed frozen shoulder reported near-immediate emotional relief and a sense of being understood

Limitations

• Most participants had already recovered at interview time, introducing recall bias and the possibility that active-disease themes would differ
• Small sample (n=10) drawn largely from a single tertiary centre in one geographic region limits generalisability
• Use of different communication platforms (in-person and telehealth) may have affected rapport and comparability of interviews
• Purposive sampling selected individuals with reported significant psychosocial impact, so the sample may not represent the full spectrum of frozen shoulder experience

Why it matters

For patients

Frozen shoulder can cause profound psychological distress including depression and suicidal thoughts, and patients should be reassured that these reactions are recognised and that effective pain management is the first priority, not just physiotherapy exercises.

For clinicians

Clinicians should screen for anxiety, depression, and social isolation early in frozen shoulder management, prioritise pain control over range-of-motion restoration, and use validating language, as feeling understood by a healthcare provider had a measurable therapeutic effect in this study.

For readers

This is the first qualitative study to describe the holistic lived experience of frozen shoulder; it argues that current treatment targets focused on biomechanics miss the condition's true burden and calls for a biopsychosocial model that centres pain management and psychological support.