A frozen shoulder is a stiff and painful shoulder that is difficult to move. It’s most common in people 40 to 70 years old.

The most common causes of frozen shoulder are medical complications (for example, recovering from a stroke or mastectomy), or injury (from a car accident). Having diabetes, lung disease, rheumatoid arthritis, and/or heart disease all increase the risk of a frozen shoulder.

Symptoms of frozen shoulder start slowly and get worse over time. They include:

• Pain, which may be worse at night, and some stiffness. This is the first and most common symptom. It’s called the freezing stage.
• Increasing stiffness that makes it harder to use your arm. This happens second and is called the frozen stage.
• Improved movement in your shoulder. This happens third and is called the thawing stage.

Most frozen shoulders get better on their own within 18 months. Treatments focus on controlling pain and restoring shoulder movement. They include:

• Pain medicines: Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen:
  • NSAIDs like ibuprofen (e.g., Advil and Motrin) help relieve pain and reduce inflammation.
  • Acetaminophen (Tylenol) relieves pain.
• Heat to reduce pain.
• Physical therapy: Gentle stretching to improve your range of motion and help recover as much movement in your shoulder as possible.
• Injection of steroids into the shoulder to relieve pain and increase function.
• Electrical stimulation of muscles and nerves to reduce pain.

Surgery is rarely needed for frozen shoulder. If you don’t get better after 18 months, surgery could loosen the tight tissues around the shoulder. Doctors do two types of surgery:

• Manipulation under anesthesia, where the surgeon moves your arm into positions that stretch the tight tissue.
• Arthroscopic surgery to cut through tight tissues and scar tissue. Done through a few small incisions, this minimally-invasive surgery helps you heal faster and with less pain.

The surgeon can do both procedures at the same time.