Frozen shoulder or 'adhesive capsulitis' is a very common condition characterized by stiffness in the shoulder joint. If you have a frozen shoulder, the range of motion in your arm and shoulder is severely limited. You will usually find shoulder pain getting worse and then eventually improving. This condition is also known as 'periarthritis' or simply 'painful stiff shoulder'.
Our shoulder joint is a ball-and-socket joint that works like a smooth machine under optimal conditions. However, over time, the joint may accumulate scar tissue causing it to become thicker than the surrounding joint. As a result, you will not be able to move it easily. This condition is frozen shoulder. Adhesions (hardened tissue) and inflammation of the joint cause pain in the shoulder.
Shoulder stiffness can be caused by advanced age (over 40), or medical conditions such as diabetes, hormonal imbalance, or a weakened immune system. Shoulder pain from frozen shoulder usually develops when you are unable to move your arm for a long period of time (usually several months) because of a serious injury or surgery.
Symptoms of Frozen Shoulder:
Since it takes a relatively long period of time for frozen shoulder to develop, peak and begin healing, the disease can be divided into three stages – freezing stage, frozen stage and thawing stage. Each of these phases has its own specific symptoms and each lasts for a few months.
Freezing Phase: Your shoulder will begin to get progressively stiffer. Moving your shoulder will cause severe pain. Shoulder pain is usually worse at night and may cause difficulty sleeping. This stage usually lasts for about 2 to 9 months.
Frozen Phase: Your shoulder will be more rigid until it is virtually immobile. Shoulder pain will start reducing. This intermediate stage usually lasts for about 4 to 12 months.
Thawing phase: There is considerable improvement in pain. Hand mobility is gradually restored during this phase. This recovery phase can last anywhere between 5 and 24 months.
What are the risk factors involved in frozen shoulder?
There are several factors that can make you more susceptible to developing a frozen shoulder.
- Age and gender: It is more commonly seen in women over 40.
- Immobility: If your arm has been in a sling or is otherwise immobile for more than two months, whether due to injury, surgery, or stroke, you may develop frozen shoulder.
- Diseases: Diabetes, cardiac disorders, tuberculosis, hypothyroidism, hyperthyroidism, Parkinson's disease, etc. put you at risk of developing this condition.
Diagnosing and Treating Frozen Shoulder
Frozen shoulder is usually diagnosed by a doctor through a physical examination that uncovers the typical symptoms of the disease seen in the patient. This is usually followed by a series of other tests, such as MRIs and X-rays, to confirm the frozen shoulder and rule out other possible diseases such as arthritis.
While a frozen shoulder may heal on its own over a period of several months to a few years if left untreated, a combination of medical treatments is highly recommended for a quick and successful recovery.
Physical therapy: The most common and effective treatment for shoulder pain is physical therapy. You will be prescribed a series of exercises which can easily be continued at home. Frozen shoulder exercises will be targeted to help stretch your joint and facilitate movement on the immobile arm. A shoulder exercise routine will ideally consist of simple and gentle free-hand exercises that increase in intensity as your mobility and pain-threshold increases.
Medications: Common anti-inflammatory medications such as aspirin and ibuprofen are commonly used to reduce shoulder pain. If the pain becomes unbearable, your doctor may prescribe you a corticosteroid injection into the inflamed shoulder joint. Steroid injections are preferred in the early stages of frozen shoulder.
Home Care: Home care is essential, especially with shoulder exercises. Ice packs are also used on the affected shoulder.
Surgery: Surgery is usually reserved as a last resort when the patient is not responding adequately to other treatments. The surgery performed is usually one of two types, the shoulder is physically subjected to a series of movements under anesthesia to break up the hardened tissue or an instrument called an 'arthroscope' is inserted through the cut and is used to remove scar tissue.
Precautions to Prevent or Manage Frozen Shoulder
For effective recovery from a frozen shoulder, treatment must be started as soon as possible. Especially if you have shoulder pain as a result of an injury, seeking medical attention early will help you recover better and be the safest path forward.
Management of concomitant diseases such as cardiac disorders, diabetes and thyroid disorders would be a good preventive measure to avoid frozen shoulder.
Frozen Shoulder FAQs:
What is the pain of frozen shoulder?
Frozen shoulder pain is usually a recurring and persistent pain that cripples the patient due to the feeling of immobility.
What is the best treatment for frozen shoulder?
The best treatment for frozen shoulder is a holistic physical therapy program. Although this is the safest and most cost-effective way of reducing shoulder pain, sometimes surgery is most appropriate, for example, if an injury is involved.
How long does it take for frozen shoulder to go away?
It can take 2- 21 months for a frozen shoulder to heal adequately. In some severe cases, recovery may not be complete. In such cases, you may find yourself struggling with mobility while doing household chores and may suffer from sporadic bursts of pain.
Is it OK to Massage Frozen Shoulder?
Massaging a frozen shoulder will be very beneficial as it will help improve circulation and soothe swelling. Applying an ice pack for 15 minutes every day is considered an integral part of home care for patients as it relaxes the muscles and reduces swelling.
How do you test for frozen shoulder?
The doctor usually diagnoses a frozen shoulder through a physical exam that measures the range of motion allowed by your shoulder and the associated pain you experience. Other tests such as MRI and X-rays confirm this diagnosis and rule out other diseases such as an impending heart attack (left shoulder pain is usually considered a symptom), arthritis, rotator cuff tears, and tendonitis.
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