Signs and Symptoms of Frozen Shoulder
If you’ve had a “frozen shoulder”, you know this is an extremely painful condition where you are unable to move your shoulder or lift your arm upward or backward, either on your own or with the help of someone else. It’s scary when everyday activities such as sleeping, dressing, washing dishes, combing hair, clasping and unclasping a bra, or reaching for a wallet in a back pocket can become difficult or impossible.
What is a frozen shoulder?
First, to clear up a misconception, frozen shoulder is sometimes confused with arthritis, but the two conditions are unrelated – whereas signs of a rotator cuff tear could be instead a frozen shoulder. Sometimes called “adhesive capsulitis”, a shoulder “freezing” occurs when the shoulder’s joint capsule membrane thickens. This tissue band surrounding the joint becomes stiff and tight and can also grow new adhesions making mobility even more difficult. View OrthoConnecticut’s animation from ViewMedica, which illustrates this process well.
Why does this happen?
It’s not well understood why the shoulder “freezes”, but these situations make it more likely to happen:
- Following swelling
- After an injury or fracture
- After surgery
- After shoulder immobilization – note it doesn’t take long for the frozen shoulder process to begin
Who does this most often affect:
- People 40 years old and older
- Females more than males – 70% of people with frozen shoulder are women.
- People with diabetes are more prone to frozen shoulder, but these conditions can also increase the risk: stroke, over or under active thyroid, cardiovascular disease, and Parkinson’s disease
Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years. The stages are fairly typical across patients:
- Freezing stage (6-9 months):
- Starts slowly, mild pain worsens over a few months
- Difficulty sleeping because of the pain
- Frozen stage (4 to 6 months):
- Movement restricted, difficulty lifting arm or moving it backwards, pain level even or decreasing
- A good self-test is to stand in front of a mirror and try to raise both arms in front of you and overhead. You may have difficulty raising the frozen shoulder arm just past parallel to the floor, plus you may find that your shoulder blade rises painfully toward your ear in an unnatural motion.
- Thawing stage (6 months to 2 years)
- Movement gets easier or returns to normal, pain may lessen or reoccur periodically
What can you do for a frozen shoulder?
See a physician for a diagnosis which may include a review of symptoms, physical exam of arms and shoulder, and x-ray or MRI to identify structural issues.
For 9 out of 10 patients, time and treatment bring relief.
Here are some options to help reduce pain and improve functionality:
- Gentle exercises: Harvard Medical School suggests these exercises to reverse stiffness: pendulum stretch, towel stretch, finger walk, cross-body reach, armpit stretch, and strengthening rotator cuff with outward and inward rotation exercises.
- Wait it out: frozen shoulder will resolve on its own but that can take up to three years, total time.
- If swollen, alternate between applying hot and cold packs to reduce pain and swelling.
- Medication: medications to reduce inflammation and can help relieve mild pain.
- Injections: your orthopedic surgeon may consider corticosteroid injections or nerve blocks.
- Physical therapy: including TENS electrical nerve stimulation, training and mobility exercises, and manipulation to unfreeze the adhesions and stretch the shoulder capsule.
- Arthroscopic Surgery: if advised by your orthopedic surgeon:
- Gentle shoulder manipulation under general anesthetic.
- Shoulder arthroscopy to remove any scar tissue or adhesions.
Here is an interesting takeaway from OrthoInfo that reviews some of the basics of a frozen shoulder.
