Understanding Frozen Shoulder: Causes, Symptoms, and Treatment

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain and stiffness in the shoulder joint, leading to a reduced range of motion. While it may develop slowly, frozen shoulder can significantly impact daily activities, making simple tasks like reaching or lifting difficult. In this post, we’ll explain what frozen shoulder is, why it occurs, and how it can be treated.

What Is Frozen Shoulder?

Frozen shoulder occurs when the connective tissue surrounding the shoulder joint, known as the shoulder capsule, thickens and tightens, restricting movement. This tightening results in stiffness, pain, and eventually a loss of range of motion. The condition typically progresses in three stages and can last for several months to years if left untreated.

What Causes Frozen Shoulder?

The exact cause of frozen shoulder is not fully understood, but several factors are believed to contribute to its development:

• Immobilization: Frozen shoulder often occurs after a period of immobilization due to injury, surgery, or illness. When the shoulder is not moved regularly, the joint becomes stiff and tight.
• Age and Gender: Frozen shoulder is most common in people between the ages of 40 and 60, and women are more likely to develop the condition than men.
• Medical Conditions: Certain medical conditions, such as diabetes, thyroid disorders, cardiovascular disease, and Parkinson’s disease, are associated with an increased risk of developing frozen shoulder.
• Shoulder Injuries: Trauma to the shoulder, such as a fracture, rotator cuff tear, or surgery, may trigger the onset of frozen shoulder.

The Three Stages of Frozen Shoulder

Frozen shoulder typically progresses through three stages, each with its own set of symptoms:

1. Freezing Stage (6 weeks to 9 months)

• In this initial stage, shoulder pain gradually increases, especially with movement.
• As the pain worsens, the range of motion in the shoulder becomes limited.
• Activities like reaching overhead or behind the back may become particularly difficult.

2. Frozen Stage (4 to 12 months)

• During this stage, the shoulder becomes stiffer, and movement is further restricted.
• Pain may start to decrease, but the limited mobility remains, affecting daily tasks and activities.

3. Thawing Stage (6 months to 2 years)

• In this final stage, the stiffness begins to improve, and the range of motion slowly returns.
• Full recovery can take time, but with appropriate treatment, most people regain normal shoulder function.

Diagnosing Frozen Shoulder

A healthcare provider will diagnose frozen shoulder based on your symptoms and a physical examination. During the exam, they may assess your shoulder’s range of motion by asking you to move your arm in different directions. Imaging tests like X-rays or MRIs may also be ordered to rule out other potential causes of shoulder pain, such as arthritis or a rotator cuff injury.

Treatment Options for Frozen Shoulder

While frozen shoulder can resolve on its own over time, medical treatment can significantly speed up recovery and reduce discomfort. Treatment options include:

1. Physical Therapy

Physical therapy is one of the most effective treatments for frozen shoulder. A physical therapist will guide you through exercises to help stretch and strengthen the shoulder muscles, gradually improving mobility. Regular therapy can shorten the duration of the frozen stage and help prevent long-term stiffness.

2. Medications

Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help reduce pain and inflammation. In some cases, your doctor may prescribe stronger medications or corticosteroid injections to provide more effective pain relief.

3. Corticosteroid Injections

Injections of corticosteroids directly into the shoulder joint can help reduce pain and inflammation, particularly in the early stages of frozen shoulder. These injections can provide relief for several weeks, allowing for more effective physical therapy.

4. Joint Distension

In some cases, joint distension, also known as hydrodilatation, is recommended. This involves injecting sterile water into the shoulder joint to stretch the capsule and improve mobility.

5. Surgery

If other treatments do not provide relief and the shoulder remains severely restricted, surgery may be considered. Two common surgical options are:

• Manipulation Under Anesthesia: While you’re under general anesthesia, the doctor moves your shoulder joint to break up the scar tissue causing stiffness.
• Arthroscopic Surgery: A minimally invasive procedure in which the surgeon makes small incisions and uses specialized instruments to remove adhesions and scar tissue from the shoulder joint.

Preventing Frozen Shoulder

While frozen shoulder cannot always be prevented, maintaining shoulder mobility and flexibility through regular movement and exercise can help reduce your risk. If you’ve had an injury or surgery that requires immobilization, working with a physical therapist to regain movement as soon as possible can be critical in preventing frozen shoulder.

When to See a Doctor

If you experience ongoing shoulder pain or stiffness that limits your ability to perform everyday tasks, it’s important to consult a healthcare professional. Early intervention can prevent the condition from worsening and may reduce the recovery time.

Conclusion

Frozen shoulder can be a painful and frustrating condition, but with proper treatment, most people recover fully over time. If you’re dealing with shoulder pain or stiffness, don’t hesitate to seek medical advice. A hand and shoulder specialist can help you develop a personalized treatment plan to restore your range of motion and get you back to your daily activities.