Your shoulder hurts like crazy and then freezes up so that daily activities become impossibly challenging. This mysterious, painful and frustrating condition is called Frozen Shoulder. We’re not 100 percent sure why it happens. What we do know is that it’s treatable and physical therapy is key to both treatment and prevention.
What Is Frozen Shoulder?
Think about everything you do that puts your shoulder to the test: reaching for something in a kitchen cabinet, picking up a child, brushing your hair–almost anything you do that involves your upper arm. These activities all involve the glenohumeral joint, the important ball-and-socket joint that connects the shoulder blade with the upper arm. When the tissues around the shoulder joint get inflamed, it can mean big problems and a Frozen Shoulder diagnosis.
Your workhorse shoulder joint is protected by a capsule filled with synovial fluid (the viscous fluid that reduces friction in our joints) and surrounded by a network of ligaments and tendons known as the rotator cuff. The connective tissue in the shoulder sometimes develops thick bands of tissue called adhesions (kind of like internal scar tissue). These adhesions cause the shoulder joint to stiffen and restrict movement, and this is what’s known as Adhesive Capsulitis or Frozen Shoulder.
What Are the Symptoms of Frozen Shoulder?
The symptom that most often brings patients to the orthopaedist is severe pain in the shoulder, followed by an inability to move the joint–either by themselves or with help. This pain/immobility pattern is a telltale sign of Frozen Shoulder. The American Academy of Orthopaedic Surgeons has identified three stages of the condition:
- Freezing: the first phase when pain worsens and the shoulder becomes harder to move.
- Frozen: the main characteristic of phase two is stiffness that impedes activity. Pain may get better during this stage, which can last for several months or more.
- Thawing: the healing that occurs as range of motion gradually returns with treatment. Patients can take months or even years to fully recover.
What Causes Frozen Shoulder?
Specific causes of Frozen Shoulder are still undetermined, but the medical community has identified several risk factors that contribute to the condition:
- Frozen shoulder is far more common in women than in men.
- It usually affects people in midlife: most cases are patients from their 40s through their 60s.
- It often occurs following an injury or surgery, including injury to the rotator cuff.
- Patients often experience Frozen Shoulder after a stroke, heart condition or surgery forces them to be immobile for an extended period.
- According to the AAOS, patients with diabetes are more than twice as likely to get a Frozen Shoulder diagnosis, so it may be connected to the regulation of blood sugar.
- Other conditions that raise the risk of a frozen shoulder include thyroid disorders and Parkinson’s Disease.
Why Do Women Get Frozen Shoulder More Than Men?
Because Frozen Shoulder often affects menopausal or perimenopausal women, some doctors believe there may be a hormonal connection to the condition. Some research suggests there may be an autoimmune component involved. However, more research needs to be done to establish a clear connection to those factors.
How Does My Orthopaedist Diagnose Frozen Shoulder?
Your doctor will start by testing your range of motion in the shoulder–including both active and passive range of motion (moving the joint both on your own and with help). Along with your medical history, he’ll talk with you about your pain and how it presents itself. Your orthopaedist can often diagnose frozen shoulder without imaging but may also use an X-ray or MRI to rule out other potential problems like arthritis.
How Can I Treat Frozen Shoulder?
Getting prompt treatment is the best way to tackle Frozen Shoulder and start the healing process. If you have unexplained pain in your shoulder or neck and/or a loss of mobility in the joint, see an orthopaedist right away. We’ll focus on relieving pain and restoring range of motion. Full recovery takes anywhere from several months to two or three years. Here are some of the most effective treatments for Frozen Shoulder:
- Your orthopaedist may prescribe a corticosteroid injection for pain relief, especially during the “freezing” phase of the condition.
- Saline injections known as distension injections (often in addition to a cortisone injection) can also help stretch out the capsule around the joint and relieve stiffness.
- Physical therapy is the “cornerstone” of treatment for Frozen Shoulder, according to Harvard Medical School. The goal is to stretch the joint capsule and strengthen tendons and ligaments around the joint to avoid further pain and improve mobility.
- Massage therapy can also help relieve pain and boost range of motion.
- Surgery is an option but is usually reserved for cases where more conservative approaches don’t work.
How Can I Prevent Frozen Shoulder?
Physical therapy is one of the keys to both treating and preventing Frozen Shoulder after an illness or injury. According to Harvard Medical School, around 10 percent of people with rotator cuff disorders get Frozen Shoulder. Physical therapy can help patients regain strength and mobility and avoid Frozen Shoulder after a rotator cuff injury or surgery. Physical therapy is also important following a stroke, heart attack or surgery as we look to keep patients moving and stretching those joints. A healthy diet rich in Omega 3s and Vitamin D can help with joint health, especially as we move into our 40s and beyond,
Suspect Frozen Shoulder? See Your Orthopaedist
If left untreated, Frozen Shoulder can not only be painful and debilitating, it can also lead to sleep problems and depression as pain and frustration mount. Getting an early diagnosis can help speed up recovery and set you up for a positive long-term outcome.
At Countryside Orthopaedics, our providers are trained to diagnose and treat a condition that primary care doctors sometimes miss. Our experience helps us to choose the best options for treatment from cortisone injections to physical therapy. We also offer a team of skilled physical therapists with Frozen Shoulder experience to guide you through exercises to help treat and prevent the condition. We believe there’s simply no reason to live with chronic pain unnecessarily, especially when we have the tools in place to treat stressful conditions like Frozen Shoulder without painkillers. It’s can be a long and challenging process, but the healing experience is well worth the work.