Frozen Shoulder: Why It Happens and How It’s Treated

Frozen shoulder — also known as adhesive capsulitis — is a common condition in which the connective tissue, or joint capsule, around the shoulder joint becomes inflamed, leading it to thicken and tighten. As this occurs, scar tissue can form.

This results in stiffness, pain, and restricted motion in the shoulder joint, and can eventually lead to loss of motion. Frozen shoulder usually develops gradually, with symptoms worsening over time.

Some people with frozen shoulder initially believe they have a rotator cuff injury, which is caused by tendons pulling away from the arm bone. Rotator cuff injuries typically cause sharp pain. They can also cause weakness, making it difficult to move the arm, especially when lifting and attempting overhead actions.

Frozen shoulder can also be mistaken for general shoulder stiffness, which is often temporary and caused by strain or overuse. This type of stiffness generally does not cause loss of motion the way frozen shoulder does.

The Three Stages of Frozen Shoulder

Frozen shoulder generally progresses in three stages, each of which can last for months or even years:

1. Freezing: At this initial stage, you’ll gradually start to experience pain whenever you try to move your shoulder, especially at night. You may also lose range of motion. Both pain and stiffness worsen over time.
2. Frozen: Once the shoulder has become “frozen,” pain will actually decrease, but you’ll have minimal to no range of motion. This can make daily tasks and activities very difficult.
3. Thawing: At the final stage, your shoulder will begin to “thaw,” with range of motion returning. However, you may experience increased pain at night or when trying to sleep. Once strength and range of motion return, full recovery is likely.

Risk Factors for Frozen Shoulder

There are various risk factors for frozen shoulder, including:

• Being over age 40
• Having a history of rotator cuff injury
• Diabetes
• Prolonged use of a sling
• Thyroid disorders, such as hypothyroidism and Hashimoto’s thyroiditis
• Recent medical procedures, such as mastectomies, which limit arm movement
• Medical events, such as a stroke, that limit arm mobility
• Parkinson’s disease, which often restricts the range of motion in the arms
• Cardiovascular disease

Treatment Options for Frozen Shoulder

There are numerous treatment options available for frozen shoulder, designed to restore mobility and reduce pain. Common treatments include:

• Physical therapy
• Anti-inflammatory medications, such as ibuprofen
• Corticosteroid injections into the shoulder joint (in severe cases)
• Hydrodilatation, a minimally invasive procedure in which fluid is injected into the shoulder joint
• Manipulation under anesthesia (so no pain is felt), often done as an outpatient procedure when other options have failed, where the shoulder is moved to its full range of motion to loosen scar tissue in the shoulder joint
• Surgery, for severe cases, in which scar tissue is removed from the shoulder joint via small, precise incisions

Conservative options will always be attempted before surgery is considered, and most patients recover fully without surgical intervention.

Get Help for Frozen Shoulder

Frozen shoulder can be very frustrating and uncomfortable to live with. If you’re suffering from the symptoms of frozen shoulder, it’s important to consult with an orthopedic specialist. Early treatment is associated with faster recovery, reduced pain, and improved mobility.

To learn more about your options for treating frozen shoulder and improving your quality of life, contact the experts at The Orthopedic Health Center.