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What is Frozen Shoulder?

Frozen shoulder, also called adhesive capsulitis, is a condition in which you experience pain and stiffness in your shoulder.  The symptoms appear slowly, worsen gradually and usually take one to three years to resolve on their own.

Causes

The shoulder joint is comprised of bones, tendons, and ligaments that are encased in a capsule of connective tissue.  Gradual thickening and tightening of this capsule surrounding the shoulder joint restrict shoulder movement causing a frozen shoulder.  It is unclear why this happens, but it is more common in women over the age of 40, patients with diabetes and/or other endocrine abnormalities.  Additionally a prolonged period of immobilization following an arm fracture or shoulder surgery can trigger this condition. 

Diagnosis

frozen-shoulder

Frozen shoulder is diagnosed with a physical exam during which your doctor will evaluate your shoulder movements and assess for pain.  You will be asked to perform certain arm movements to check the active range of motion and you will be asked to maneuver your arm in different directions to check the passive range of motion.  

Signs and Symptoms 

The signs and symptoms of frozen shoulder develop gradually in three stages with each stage lasting for several months.

  • The first stage is the freezing stage during which pain occurs with any shoulder movement and the range of motion of the shoulder gradually becomes limited.  Pain may worsen at night disrupting sleep.
  • Next is the frozen stage where the pain subsides but your shoulder stiffens up and cannot function properly.  The final stage is the thawing stage during which shoulder movement begins to gradually improve.

Imaging studies such as an X-ray or MRI may be ordered to view the shoulder joint and rule out other problems.

Treatment

The various treatments used for frozen shoulder include:

  • Pain-relieving medications
  • Ice packs or heat application
  • Physical therapy exercises
  • Acupuncture
  • Intra-articular injections
  • Manipulation of the shoulder after administering anesthesia
  • Surgery in the most difficult of cases

Adhesive capsulitis is a condition that requires time and patience.  You will unlikely get better immediately, however this is not a failure of treatment.  Overtime your treatment will be adjusted accordingly, however conservative options are the mainstay of treatment with surgical intervention reserved for the most complex cases. 

  • American Academy of Orthopaedic Surgeons
  • American Shoulder and Elbow Surgeons
  • Orthopaedic Trauma Association
  • Weill Cornell Medicine
  • AANA Advancing the Scope