Frozen Shoulder

Overview

Frozen shoulder, also known as adhesive capsulitis, is an orthopedic condition that affects the shoulder joint. The primary symptoms of frozen shoulder are pain and stiffness that develop gradually. Symptoms from frozen shoulder can take up to three years to go away.

When you have a frozen shoulder, the capsule (the tissue that surrounds the shoulder joint), becomes tight or thick. When this occurs, scar tissue begins to form, and there is less synovial fluid in the joint to keep it lubricated. Ultimately, this limits shoulder mobility and movement.

Frozen shoulder causes

It’s unclear why some people develop frozen shoulder. In other people, it is caused by inflammation, scarring, and thickening of the capsule around the shoulder joint.

Other orthopedic conditions that can lead to a frozen shoulder include:

• Tendinitis
• Bursitis
• Rotator cuff injury

Any condition that requires long-term immobility of the shoulder can lead to a frozen shoulder.

Frozen shoulder symptoms

• Pain and stiffness in the shoulder
• Difficult or impossible to move your shoulder
• Dull or achy pain
• Pain in shoulder muscles
• Pain gets worse at night

Frozen shoulder complications

The primary complication of a frozen shoulder is stiffness or pain. Some people have pain for as long as three years after treatment. In rare cases, patients have reported a biceps tendon rupture or humeral fracture after shoulder manipulation.

Frozen shoulder risk factors

While the cause of frozen shoulder is unknown, some groups of people are more at risk:

• Women: Women are more likely than men to get a frozen shoulder.
• Age: People between the ages of 40 and 60 are more likely to get it.
• Medical history: If you have had an injury in the past or surgery that keeps you from moving your arm.

Certain medical conditions put you at a higher risk of developing a frozen shoulder. These include:

• Diabetes – as many as 20% of people with diabetes eventually are diagnosed with frozen shoulder
• Heart disease
• Thyroid disease
• Parkinson’s disease

Frozen shoulder prevention

While the cause of frozen shoulder is unknown, you can take preventative steps to decrease your chances of developing it. They include:

• Perform daily gentle, progressive range-of-motion exercises
• Stretch the area — ask your doctor the best stretches to do for your shoulders
• Strengthen your shoulder

Frozen shoulder diagnosis

You doctor will be able to diagnose frozen shoulder during a physical exam. During the exam, he or she will take a full medical history to understand any potential causes of your symptoms. To confirm your diagnosis, your doctor may also order an ultrasound, X-ray, or MRI.

Frozen shoulder treatment

• Medications - As a first-line treatment, your doctor may prescribe you non-steroidal anti-inflammatory medications to help with the pain.

• Exercises that strengthen and stretch the shoulder - To help increase your range of motion, your doctor may recommend physical therapy to strengthen and stretch the shoulder muscles.

If symptoms intensify, other treatments include:

• Corticosteroid injection: An injection in the shoulder to help with pain and improve range of motion.
• Joint distension: An injection of water into the shoulder capsule to expand it and help with motion.
• Shoulder manipulation: Used to loosen the shoulder tissue but rarely done anymore because arthroscopic surgery has replaced it.
• Surgery: Used as a last resort option

When should I seek care?

If you are experiencing shoulder pain and stiffness or other symptoms related to frozen shoulder, contact your doctor to make an appointment.

Next Steps

Your doctor will be able to recommend the best treatment for your case. Initially, he or she may recommend lifestyle changes or anti-inflammatory medication to prevent risk factors associated with a frozen shoulder.

While the cause of frozen shoulder is unknown, your doctor may tell you to do simple shoulder movements and exercises to help prevent frozen shoulder.

Call your doctor right away if your symptoms change or worsen.