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Frozen Shoulder

What is Frozen Shoulder?

Shoulder Pain

Frozen shoulder, otherwise known as adehsive capsulitis, is characterized by pain and stiffness in the shoulder joint. Symptoms begin gradually, then worsen – making the shoulder hard to move – and finally resolve.

Frozen Shoulder Causes and Risk Factors      

While the causes of frozen shoulder are uncertain, certain risk factors increase the chances of developing the condition. Risk factors for adhesive capsulitis  include:

  • People aged 40-60
  • Female
  • Recovery from a procedure which affects arm mobility – i.e. a mastectomy or stroke
  • Shoulder immobilization following fracture, surgery, or injury
  • Diabetes (10-20% of individuals with diabetes experience frozen shoulder)
  • Conditions such as Parkinson’s disease, hyperthyroidism, cardiac disease

Symptoms of Frozen Shoulder

The painful shoulder condition is characterized by the following signs and symptoms:

  • Dull ache which increases over time to sharp pain
  • Pain located over the outer shoulder area and into the upper arm
  • Difficulty rotating and elevating the arm, which is typically stiff and inflamed
  • Difficulty reaching behind the back
  • Pain when stress is put on the shoulder joint, i.e. reaching, lifting, carrying, pulling, lying on the affected shoulder
  • Pain often worse at night and in the cold (trouble sleeping)
  • Typically affects only one side but may develop in both shoulders

Frozen Shoulder Stages

Frozen shoulder is characterized by the following three stages or phases:

  1. Freezing Stage: Shoulder gradually becomes stiff as pain worsens, culminating in a loss of range of motion or ‘freezing’ of the shoulder. Typically lasts 6 weeks to 9 months.
  2. Frozen Stage: 4-6 month phase during which daily activities and arm movements are severely restricted; stiffness remains; pain gradually decreases
  3. Thawing Stage: Over a period of 6 months to 2-3 years, the condition gradually improves as the shoulder loosens up or “thaws,” returning to normal or near-normal strength and mobility

Treatment for Frozen Shoulder

The goal of treatment for frozen shoulder is to reduce/control pain and to restore strength and mobility via the following:

  • Anti-inflammatory medications to reduce pain and swelling
  • Cortisone injections in the shoulder joint
  • Physical therapy
  • Soft tissue massage
  • Shoulder stretching exercises
  • Exercises which increase shoulder range of motion

If symptoms do not improve, surgery to loosen the stiff joint capsule may be required. Surgical treatments for frozen shoulder include:

  • Shoulder manipulation under anesthesia
  • Shoulder arthroscopy

Frozen Shoulder Prognosis

The good news is that over 90% of individuals improve and restore motion without surgery. Similarly, long-term outcomes for frozen shoulder surgery are very good.