Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, or adhesive capsulitis, is a painful condition where movement of the shoulder becomes limited. Symptoms develop gradually, worsen, and then resolve, generally over the course of one to three years. For most people, resolution of symptoms happens naturally, without the need for surgery.

Overview

Your shoulder is often referred to as a ball-and-socket joint. It has three bones: the upper arm bone, the shoulder blade, and the collarbone. The head of the upper arm bone fits into a shallow socket in the shoulder blade and a group of strong connective tissues surrounds the joint. These tissues are also called the joint capsule. When they become thick, stiff, and inflamed, movement becomes very painful.

This condition is called frozen shoulder because as more pain is felt, the shoulder is less likely to be used. Because it is getting used less, the shoulder capsule thickens and becomes tight. This makes the shoulder even more difficult to move, essentially causing it to be frozen in place.

Frozen Shoulder Causes

Frozen shoulder affects people between the ages of 40 and 60 the most. It is also more common in women than men. Doctors aren’t sure why this condition affects some people and not others. However, they have been able to identify certain risk factors that seem to make some people more likely to develop it. 

• Recent Shoulder Injury: Any shoulder injury or surgery that requires keeping the shoulder immobile can increase the risk of developing frozen shoulder. Specifically, a rotator cuff tear, shoulder blade fracture, and a collarbone or upper arm tear can also increase the risk.
• Diabetes: About 10-20% of individuals with diabetes mellitus develop frozen shoulder.
• Stroke: This is a major risk factor since movement of an arm and shoulder may be limited.
• Other Conditions: Although unclear why, other conditions like stroke, hypothyroidism, hyperthyroidism, Parkinson’s disease, and heart disease can increase the risk of frozen shoulder.

Frozen Shoulder Symptoms

There are three stages of frozen shoulder symptoms, termed the freezing, frozen, and thawing stage. For some people, the symptoms will be the worst at night and could possibly interrupt sleep.

• “Freezing” Stage: The shoulder will become stiff and painful to move, with the pain slowly increasing. It might get worse at night and the difficulty moving the shoulder increases. This stage of the condition could last 6 weeks to 9 months.
• “Frozen” Stage: The pain in the shoulder lessens, but it still remains stiff. Difficulty completing daily tasks and activities may increase. This stage usually lasts between 2 to 6 months.
• “Thawing” or Recovery Stage: Now, the pain lessens and the ability to move the shoulder gradually improves. As normal strength and function return, a patient reaches full or near full recovery. This stage can last 6 months to 2 years.

Frozen Shoulder Treatment

The treatments for frozen shoulder usually focus on pain relief until a patient makes it through the freezing stage. Hot and cold compresses and NSAIDs may be used to reduce pain and swelling in the shoulder. Stretching and range of motion exercises recommended by a physical therapist can help regain range of motion. The success of these exercises depends on a patient’s commitment to performing these exercises as recommended.

While most cases of frozen shoulder will improve on their own, your doctor might recommend a steroid injection for persistent symptoms. Injecting corticosteroids might help decrease pain and improve mobility, particularly towards the beginning of the condition.

In only a small number of cases arthroscopic surgery is necessary. The goal of the procedure will be to loosen the joint capsule so that it can move more freely 

Frozen Shoulder at OAR

If symptoms of frozen shoulder are interfering with your daily life or are not improving on their own, it might be time to make an appointment at Orthopaedic Associates of Riverside. We can examine your shoulder to correctly diagnose you and recommend treatment.