Frozen Shoulder

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What is frozen shoulder?

Frozen shoulder, also known as adhesive capsulitis, causes pain and stiffness in the shoulder. With time, the shoulder becomes very hard to move.

Frozen shoulder commonly affects middle-aged people and occurs in women more often than men. People with diabetes are at an increased risk of developing frozen shoulders.

 

Stages of frozen shoulder

There are 3 stages of frozen shoulder. 

Stage 1: Freezing

In the "freezing" stage, your pain is getting worse. As the pain worsens, your shoulder stiffens. Freezing stage usually lasts from 6 weeks to 9 months.

Stage 2: Frozen

Painful symptoms may improve during this stage, but the stiffness remains. Daily activities may be challenging during the 4 to 6 months of the "frozen" stage. The range of motion in the joint is limited.

Stage 3: Thawing

Shoulder motion gradually improves during the "thawing" stage. The shoulder typically takes six months to 2 years to return to normal.

 

Symptoms of frozen shoulder

Pain from a frozen shoulder is usually dull or aching. It is typically worse early in the disease and when you move your arm. The pain is generally located over the upper arm.

 

When should I seek medical help?

There are circumstances when shoulder pain might be caused or accompanied by severe issues. If such symptoms are present, it is best to seek immediate medical attention to avoid further complications:

  • Shoulder pain with a fever, swelling, or redness

  • Difficulty sleeping due to pain or discomfort of the affected shoulder

  • Difficulty or pain when attempting to reach backwards, raise your arm over your head, or reach across your body

  • Pain for more than two weeks, even after home treatment

  • A joint that appears deformed

  • A previous dislocation of the shoulder

 

Diagnosis

To diagnose any dislocation in your shoulder, your doctor will take your case history and past medical history into account. They will move your shoulder carefully in all directions to see if movement is limited and if pain occurs with the motion. The range of motion when someone else moves your shoulder for you is called the "passive range of motion." People with frozen shoulders have a limited range of motion, both actively and passively.

 

Imaging is not required in diagnosing a frozen shoulder. However, it may help to identify other problems in your shoulder, such as a torn rotator cuff or other shoulder problems.

 

Treatment

Frozen shoulder gets better over time. However, it may take up to two years. The treatment focuses on controlling pain and restoring motion and strength through physical therapy. Most people with frozen shoulders improve with simple treatments, which include: 

  • Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and swelling.

  • Steroid injections. Cortisone is a powerful anti-inflammatory medicine injected directly into your shoulder joint to reduce pain. 

  • Physical therapy. Specific exercises will help restore motion. Treatment includes stretching or joint mobility exercises for the shoulder.

If your symptoms are not relieved by nonsurgical methods, your doctor may discuss surgery with you.

The goal of surgery is to release the stiffened joint capsule.