Frozen Shoulder

Understanding Frozen Shoulder: Symptoms, Causes, and Treatment

frozen shoulderFrozen shoulder is also known as adhesive capsulitis and is a condition noted by stiffness and pain in the shoulder joint. Over time, the shoulder becomes more difficult to move and can significantly impact daily activities. Understanding the causes and symptoms is crucial for early diagnosis and effective treatment management options.

Causes

The cause of frozen shoulder involves thickening and tightening of the capsule that surrounds the shoulder joint. Factors that may contribute to the development include:

  1. Age and Gender: Individuals between the ages of 40 and 60, especially women, are more likely to develop frozen shoulder.
  2. Diabetes: Individuals with diabetes are at a higher risk
  3. Immobility: Long periods of shoulder immobility due to surgery, fractures, or other shoulder injuries.
  4. Systemic Diseases: Such as heart disease, thyroid disorders, and Parkinson’s disease, can increase the risk.

A 2024 study in Scientific Reports indicated that cervical spondylosis, low Body Mass Index (BMI), diabetes, and hyperlipidemia were significant risk factors for the occurrence of frozen shoulder.

Symptoms

It typically develops in three stages, each with its own set of symptoms:

  1. Freezing Stage: Gradual onset of pain that worsens over time, leading to limited shoulder movement. This stage can last from 6 weeks to 9 months.
  2. Frozen Stage: Pain may not be as bad, however the shoulder remains stiff. This can last from 4 to 12 months.
  3. Thawing Stage: Gradual improvement in shoulder movement and a reduction in pain. This stage can last from 6 months to 2 years.

frozen shoulder relief

Diagnosis

Diagnosing frozen shoulder involves a combination of medical history review, physical examination, and imaging tests:

  1. Medical History: Discussing symptoms and effects with a healthcare provider.
  2. Physical Examination: Assessment of the shoulder’s pain response and range of motion.
  3. Imaging Tests: X-rays or MRI scans can be used to rule out other conditions like as arthritis or rotator cuff tears.

Treatment Options

Treatment for frozen shoulder focuses on relieving pain and restoring shoulder movement. Options include:

  1. Medications: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage pain. In some cases, doctors may prescribe stronger medications or injections.
  2. Therapy: Shoulder exercises improve range of motion as well as strength tailored to the individual’s needs.
  3. Heat and Cold Therapy: Applying heat or ice packs to the shoulder can help reduce both pain and inflammation.
  4. Hydrodilatation: This is a procedure that involves injecting a large volume of sterile fluid into the joint capsule to expand and stretch the tissue.
  5. Surgery: In severe cases, when other treatments have failed, arthroscopic surgery may be necessary to release the tightened capsule.

A 2019 study in the Journal of the American Academy of Orthopaedic Surgeons indicates most patients see a complete resolution of symptoms with nonsurgical management, and early corticosteroid injections may shorten the duration of symptoms.

A 2024 study in the Journal of Shoulder and Elbow Surgery indicates there is contracture and thickening of the coracohumeral ligament in patients with adhesive capsulitis, which adversely affects movement and function of the shoulder joint. Significant improvements in functional scores, pain, range of motion and disability scores, were obtained 12 weeks with a guided corticosteroid injection.

Prevention

Preventing frozen shoulder consists of maintaining adequate shoulder mobility and addressing any underlying health conditions. Regular shoulder exercises can help keep the joint flexible. Managing chronic conditions such as diabetes and thyroid disorders is also essential.

While frozen shoulder is both painful and debilitating and significantly impacts daily life, the early diagnosis and treatment are critical for successful recovery. Understanding the causes, symptoms, and treatment options, individuals can take necessary steps in management and prevention, improving shoulder health and overall well-being.

Author Bio

Stephen Ornstein, D.C. has treated thousands of neck, shoulder and back conditions since graduating Sherman Chiropractic College in 1987 and during his involvement in Martial Arts. He holds certifications as a Peer Review Consultant from New York Chiropractic College, Physiological Therapeutics from National Chiropractic College, Modic Antibiotic Spinal Therapy from Dr. Hanne Albert, PT., MPH., Ph.D., Myofascial Release Techniques from Logan Chiropractic College, and learned Active Release Technique from the founder, P. Michael Leahy, DC, ART, CCSP.