Frozen shoulder doesn’t refer to a cold shoulder, temperature, or frostbite. Instead, this term refers to pain and loss of movement in the shoulder joint. And “frozen shoulder” is easier for more people to remember than adhesive capsulitis.
Frozen shoulder describes pain and loss of movement in the shoulder.
The shoulder is a unique joint. It brings together the bones of the upper arm (humerus), shoulder blade (scapula), and the collarbone (clavicle). The shallow ball-and-socket allows the arm to rotate freely and move forward, backward, up, and down. The muscles, ligaments, tendons, and bones must move together smoothly to perform these movements.
Shoulders immobilized with a sling are more susceptible to adhesions.
When not moving, soft joint tissues can become inflamed and thick. Lack of movement also may decrease the level of synovial fluid that lubricates the joint capsule. Either factor can cause shoulder pain and stiffness.
People often experience frozen shoulder in three stages.
The freezing stage starts first. It’s the most painful. As adhesions form, they cause pain and limit movement. This stage lasts between six weeks and nine months.
During the frozen stage, arm movement is nearly impossible. While pain is not as severe, the ability to perform daily living tasks is difficult. This phase can last up to a year.
When the thawing stage begins, people report more normal function and movement. It may take six months to two years for people to return to their pre-frozen function.
For some, it might take up to three years to recover completely.
What causes frozen shoulder?
There’s no definite cause for the condition. But, there are some related risk factors.
When injury or surgery affects the shoulder joint, treatment often includes immobilization with a sling. This is a major risk factor for frozen shoulder.
The disorder often affects people between 40 and 60 years old more often than people of other ages. Statistics show women are more susceptible than men. Other risk factors include bursitis, tendonitis, and soft tissue inflammation.
Chronic conditions such as diabetes, thyroid issues, Parkinson’s disease, and cardiovascular disease can also play a part in the development of frozen shoulder.
How is frozen shoulder diagnosed?
An orthopedic provider diagnoses frozen shoulder using a physical exam and medical imaging.
During the physical exam, the provider will manually move the shoulder. Then the provider will ask the patient to perform the same motions. He or she will note the differences between assisted and independent range of motion. The provider may order X-rays, MRIs, CT scans, or ultrasound to look inside the shoulder joint.
Once the provider makes a formal diagnosis, treatment can begin.
How is frozen shoulder treated?
Physical therapy and gentle exercises may be prescribed. These exercises can improve flexibility, reduce pain, and restore movement. Some may even prevent adhesions. Physical therapy is often one of the first treatments recommended by sports medicine specialists.
An orthopedic provider also may order other treatments to help relieve severe pain and discomfort, including:
- Steroid or corticoid steroid injections
- Transcutaneous electrical nerve (TENS) stimulation
- Physical therapy to improve shoulder movement
- Hydrodilation, a treatment that expands and stretches the joint capsule. During the treatment, the provider injects sterile fluid into the shoulder joint.
Sometimes, surgery is required.
Five things you can do at home to relieve the pain and discomfort of frozen shoulder.
- Use ice packs and over-the-counter medications to reduce shoulder pain.
- Warm up the shoulder for 15 minutes before exercising.
- Work with a physical therapist or sports medicine specialist.
- Avoid movements that make the pain worse.
- Practice pendulum swings. This commonly prescribed exercise uses the arm’s weight to create small circular rotations. This movement snaps adhesions and prevents them from getting worse.
Rarely does frozen shoulder recur, but it’s possible
When should I go to the doctor for a frozen shoulder?
If you experience shoulder pain or loss of movement, make an appointment with an orthopedic provider. Several of Bone & Joint’s specialists treat shoulder pain. Call 800-445-6442 or request an appointment online.