Frozen shoulder, adhesive capsulitis, causes pain and stiffness in the shoulder and the shoulder becomes difficult to move. Frozen shoulder occurs in about 2% of the general population, affecting people between 40 and 60 and women more than men.
The shoulder is a ball-and-socket joint made up of three bones: the upper arm bone (humerus), shoulder blade (scapula), and collarbone (clavicle). The head of the upper arm bone fits into a shallow socket in the shoulder blade. Connective tissue called the shoulder capsule surrounds the joint. Synovial fluid lubricates the shoulder capsule and the joint.
In frozen shoulder, the shoulder capsule thickens and bands of tissue called adhesions develop. In many cases, there is less synovial fluid in the joint.
The hallmark sign of this condition is the inability to move the shoulder, often accompanied by pain and inflammation. Frozen shoulder develops in three stages:
- In the “freezing” stage, the pain worsens and the shoulder loses range of motion. It takes 6 to 9 months to freeze.
- Once frozen, daily activities become difficult for 4 to 6 months. It’s hard to put on a shirt or seatbelt or reach for a book on a shelf.
- During thawing, shoulder motion slowly improves and the shoulder returns to close to normal strength and motion. Thawing typically takes from 6 months to 2 years.
The causes of frozen shoulder are not fully understood. Some risk factors for developing frozen shoulder include diabetes, hyperthyroidism, Parkinson’s disease, cardiac disease, and post immobilization due to surgery.
After discussing symptoms and medical history, the DOC PA or orthopedic surgeon will examine the shoulder for range of motion. Imaging tests, X-rays and MRI, will help the physician rule out other causes of stiffness and pain. Frozen shoulder generally gets better over time, a long time, up to 3 years. The focus of treatment is to control pain and restore motion and strength. Non-steroidal anti-inflammatory medicines or steroid injections directly into the shoulder are anti-inflammatory and pain relief options. Specific physical therapy exercises may help restore motion.
Dr. Sean Hassinger, orthopedic surgeon with DOC, explains: “At DOC, we recommend conservative treatment first. If symptoms are not relieved by anti-inflammatory medicines, injections and therapy, then surgical intervention may be indicated to stretch and release the stiffened joint capsule.”
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