# Frozen Shoulder (Adhesive capsulitis) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: BESS Guidelines for Management of Frozen Shoulder 2015 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) - Verified date: 2026-08 ## Verified against - Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) - Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) - Adhesive Capsulitis (Frozen Shoulder) - disease-level clinical article (frozen-shoulder-clinical.txt) ## Treatment metadata - Ibuprofen — 400 mg — oral.solid - Referral & safety-netting (no drug therapy) - Naproxen — 500 mg — oral.solid ## Complete treatment card ```text FROZEN SHOULDER (ADHESIVE CAPSULITIS) Sources: BESS Guidelines for Management of Frozen Shoulder 2015 · Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) · Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) Review status: REVIEWED against Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560), Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639), Adhesive Capsulitis (Frozen Shoulder) - disease-level clinical article (frozen-shoulder-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Pain builds gradually then stiffens the joint, worsening over weeks to months - Initial pain gives way to stiffness, then a constant dull ache with sharp jabs on sudden movement or extreme reach [joint pain · shoulder pain] - The condition can last anywhere from a few months up to 2 to 3 years before resolving - The problem is scarring of the joint capsule itself, not the muscles or the tendons around it [scarring] - It picks out middle-aged adults, and diabetes or thyroid disease makes it both likelier and more severe - Red flag: it is commonly missed, and the delay is what turns it into long disability SIGNS - what you find (5) - Both active and passive range of motion are markedly reduced across flexion, abduction, and rotation [reduced range of movement] - Motion is typically lost in a set order - external rotation first, then abduction, internal rotation, and flexion - Diffuse tenderness is found on palpation around the joint, while distal neurological exam stays intact - Neer, Hawkins, and Speed special tests are frequently positive as well - In advanced cases the arm no longer swings naturally on walking, and disuse-related muscle wasting can appear [muscle wasting] TESTS (3) - Routine blood tests are skipped unless an underlying condition such as diabetes or thyroid disease is suspected - X-ray excludes bone disease; MRI can show a thickened coracohumeral ligament or a shrunken axillary pouch - A subacromial lidocaine injection fails to restore motion here, unlike bursitis or cuff tendinopathy Source StatPearls "Adhesive Capsulitis (Frozen Shoulder)" - disease-level clinical article Status traced to the source above 1. IBUPROFEN [1st line] Adult 400 mg 3 times daily after meals Peds Rare condition in children; specialist referral needed Source Ibuprofen 100 mg/5 ml SmPC section 4.2 (eMC product 4560) Why Non-selective NSAID that controls the inflammatory pain of frozen shoulder, used alongside early gentle physiotherapy, which is the primary driver of recovery. Caution Combines with early gentle physiotherapy within pain tolerance. Screen for underlying diabetes mellitus or thyroid dysfunction. Egypt DAJUANOFEN 400 MG 20 F.C. TABS. COPAD PHARMA 5.00 EGP (0.25/unit) FLABU 400MG 10 F.C.TAB. DELTA PHARMA 3.75 EGP (0.38/unit) NOVA-PROFEN 400MG 30 F.C. TABLETS SANOFI 12.75 EGP (0.42/unit) IBUPROFEN 400 MG 10 TAB. SEDICO 6.00 EGP (0.60/unit) MAFO 400 MG 30 F.C.TABS EIPICO 42.00 EGP (1.40/unit) BRUFEN 400 MG 30 TABS. KAHIRA > ABBO... 78.00 EGP (2.60/unit) PROFUSOL 400MG 20 S.G CAPS. EUROPEAN EGYP... 31.00 EGP ANALGIPROF 400 MG 25 SACHETS EVA PHARMA 37.50 EGP NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML SANOFI 2.25 EGP -> ? strength differs, ? different route - not oral solid BRUFEMOL-N SUSP. 60 ML ARAB DRUG COM... 4.50 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Adhesive Capsulitis (Frozen Shoulder) - disease-level clinical article (frozen-shoulder- clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - New-onset arm weakness or numbness, or worsening symptoms, should prompt further medical evaluation as these suggest a diagnosis other than adhesive capsulitis (not just continued NSAID use). 3. NAPROXEN [2nd line] Adult 500 mg twice daily after meals Peds Specialist referral required Source Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) Why Longer-acting NSAID alternative to ibuprofen for frozen shoulder, chosen when nocturnal pain persists between doses of a shorter-acting agent. Caution Naproxen is a longer-acting NSAID alternative for persistent nocturnal pain. Refer for intra-articular steroid injection if pain prevents physiotherapy. Contraindicated in baseline creatinine clearance <30 ml/min and during the last trimester of pregnancy. Egypt ORGOPROXEN 500 MG 20 TAB. ORGANOPHARMA ... 16.00 EGP (0.80/unit) NAPROSYN 500 MG 10 TAB. MISR > F.HOFF... 8.05 EGP (0.81/unit) NAPROFEN 500MG 10 TAB. EL NILE. 12.00 EGP (1.20/unit) NAPROFEN 500MG 20 TAB. EL NILE. 24.00 EGP (1.20/unit) Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)