Frozen Shoulder

Frozen shoulder (adhesive capsulitis) is a condition characterized by stiffness and pain in the shoulder. This condition is most likely to develop after a procedure or medical condition that limits the shoulder’s range of motion for a long period of time, such as a stroke or a mastectomy. 

Signs and symptoms of frozen shoulder will generally build gradually and resolve themselves, usually over the course of one to three years.

Shoulder Anatomy

The shoulder is a joint comprised of three bones: the upper arm, the shoulder blade, and the collarbone. 

These bones, as well as the ligaments and tendons that connect them and bind them to their corresponding muscles, are encased in a capsule of connective tissue.

Frozen shoulder occurs when this capsule thickens and tightens around the joint, restricting movement.

Frozen Shoulder Causes

Doctors aren’t particularly sure why frozen shoulder occurs in some people but not in others. However, there are certain demographics that are statistically more likely to develop it than others, such as:

  • Age and biological sex. People over the age of 40 are more likely to develop frozen shoulder. Women are also more likely than men to develop it.
  • Immobility or reduced mobility. People whose shoulders have been rendered immobile either completely or partially for a prolonged period of time are at greater risk for frozen shoulder. Immobility can be a result of multiple factors, but the most common include rotator cuff injuries, a broken arm, a stroke, or recovery from surgery.
  • Systemic diseases. People with certain diseases seem more likely to develop frozen shoulder. Diseases that appear to increase the risk of frozen shoulder include diabetes, tuberculosis, Parkinson’s, or various thyroid issues.

Frozen Shoulder Symptoms

Frozen shoulder develops slowly and has three stages. Each stage can last a number of months.

  • Freezing stage. During this stage, any shoulder movement causes pain. The shoulder is slightly stiff, and the range of motion has started to become limited.
  • Frozen stage. The pain will likely lessen during this stage, but the shoulder will be incredibly stiff. Moving it will be very difficult.
  • Thawing stage. The range of motion in the shoulder will begin to improve.

Many people experience the most severe pain at night, and it can disrupt their sleep. 

Frozen Shoulder Diagnosis

To diagnose frozen shoulder, your doctor will perform a physical examination of your arm. During the physical exam, your doctor will ask you to move your shoulder in specific ways to check your range of motion. This is testing your active range of motion.

Frozen shoulder can often affect passive range of motion. To test this, your doctor will ask you to relax your arm muscles while they move your arm for you.

If the shoulder is extremely painful, your doctor may use a numbing medicine to help reduce pain while determining active and passive range of motion.

A diagnosis of frozen shoulder can usually be determined through signs and symptoms, along with the physical exam. However, imaging tests such as X-rays and MRIs can be used to rule out other potential shoulder injuries.

Frozen Shoulder Treatment

The majority of treatments for frozen shoulder involves managing shoulder pain while regaining and preserving as much range of motion as possible. This is achieved through a combination of medications and physical therapy.

Over the counter pain relievers like aspirin and ibuprofen can help reduce the pain or inflammation associated with frozen shoulder.

A physical therapist can also teach you gentle exercises designed to increase and preserve your normal range of motion. Completing these exercises as directed is essential to optimizing your recovery.

Surgery and Other Procedures for Frozen Shoulders

Most cases of frozen shoulder resolve themselves within 12 to 18 months, with help from doctors to manage pain. For persistent symptoms, there are a few minimally invasive procedures and surgical options available, such as:

  • Steroid injections. Corticosteroids injected into the shoulder joint can help decrease pain and improve shoulder mobility
  • Joint distension. Your doctor may inject sterile water into the joint to help stretch the tissues in the capsule. This will release pressure on the joint and make movement easier.
  • Shoulder manipulation. Your doctor will place you under general anesthesia for this procedure, so you will not be awake at all. The doctor will move and manipulate your shoulder to help loosen tissues.
  • Surgery. This is the least common treatment for frozen shoulder and is typically utilized as a last resort. Surgery can be used to remove scar tissue or any adhesions from inside the shoulder joint. This surgery is usually performed arthroscopically (with small cameras guiding tiny, pencil-like surgical tools) and is minimally invasive.

Frozen Shoulder Prevention

The best way to prevent a frozen shoulder injury is to be proactive. If you’ve had an injury or any procedure which has rendered your arm immobile, talk to your doctor about any exercises you can do at home to maintain strength and range of motion in your shoulder.

At SPORT, we will identify the source of your pain and then utilize state-of-the-art therapeutic techniques that focus on restoring your range of motion.

Depending on the specific condition and its severity, these treatment options may include physical therapy, over-the-counter anti-inflammatory medication, slings and supports, cortisone shots, or shoulder or elbow surgery.

If you have an acute or chronic shoulder or elbow injury that needs medical attention, call SPORT at (469) 200-2832 to arrange a consultation or you can request one online. Hurt today? We can arrange a same-day urgent care visit to ensure you get fast, effective relief.

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