When you’re unable to move your shoulder due to stiffness or pain, it can cause worry about whether your symptoms will improve or if you’ll still be able to participate in your favorite activities. The shoulder specialists at The Ohio State University Wexner Medical Center in Columbus, Ohio, understand how important it is to get you back to enjoying life when you’re experiencing a painful condition like frozen shoulder. Our orthopedics team will customize a treatment plan for you that will alleviate pain and symptoms.
What is frozen shoulder?
Frozen shoulder (adhesive capsulitis) is a condition that causes stiffness and pain in the shoulder joint without any specific injury or trauma. This happens because the shoulder capsule, which is the connective tissue that surrounds the joint, thickens or stiffens.
Sometimes the capsule develops thickening, or there’s a decrease in the fluid that lubricates the joint, further creating an environment where the shoulder cannot move.
It often takes months or years for the shoulder to return to normal function, but expert orthopedic treatment can help prevent a frozen shoulder from getting worse and shorten the time it takes to recover.
Stages of frozen shoulder
Frozen shoulder typically worsens over time, especially if not treated, before getting better. It progresses in these stages, which include:
- Stage one, freezing: Certain shoulder movements begin to cause pain. This progresses for two to nine months until any movement is painful. Because of the pain, your shoulder’s range of motion becomes limited.
- Stage two, frozen: While pain may actually decrease during this stage, stiffness increases, making it nearly impossible to move the shoulder. With this stage lasting four to six months, daily living can become challenging.
- Stage three, thawing: This occurs when the range of motion begins to improve. Most people will see a full return to normal strength and range of motion in the shoulder in nine months to two years.
What causes frozen shoulder?
It’s not entirely clear what causes frozen shoulder, but you can be at risk if you keep your shoulder still for long periods of time. Other risk factors for frozen shoulder include:
- Age – The condition most often affects those ages 40 to 60.
- Sex – More females than males experience frozen shoulder.
- Recent injury – If you had a recent incident, such as a rotator cuff tear, broken arm, stroke or shoulder surgery, that rendered you immobile, you may be at greater risk for frozen shoulder.
- Certain conditions – People with certain conditions, such as diabetes, thyroid disease, cardiovascular disease or Parkinson’s disease, experience frozen shoulder at a greater rate than those without.
While you may have one or more of these risk factors, it doesn’t necessarily mean you will develop frozen shoulder. Talk with your doctor if you’re concerned about developing frozen shoulder following surgery or injury.
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Frozen shoulder symptoms
The hallmark symptoms of adhesive capsulitis include pain and stiffness in the shoulder. Symptoms may include:
- A dull aching that is typically worse in the early part of the condition
- Limited range of motion that progresses to immobility
- Pain that’s usually located in the outer shoulder area or the upper arm
- Trouble sleeping, since symptoms can sometimes worsen at night
How is frozen shoulder diagnosed?
The shoulder experts at the Ohio State Wexner Medical Center will use a variety of diagnostic tools to accurately identify frozen shoulder as the cause of your symptoms. To diagnose your condition, we might recommend:
- A physical examination: Your doctor will ask about your history of symptoms and risk factors. A physical examination of how you’re able to move your arm actively (yourself) or passively (the doctor moving it for you) will be important to diagnosis. People with frozen shoulder have limited ability to move their arm actively and passively.
- Imaging: People with frozen shoulder don’t always need imaging tests, such as X-rays, magnetic resonance imaging or ultrasounds, to have their condition diagnosed. Your shoulder specialist may recommend them to rule out other conditions that cause shoulder pain.
What conditions can be confused with frozen shoulder?
It’s important to get an accurate diagnosis for your shoulder pain to get the proper treatment. Sometimes frozen shoulder can be mistaken for other conditions, such as arthritis or a rotator cuff tear.
Frozen shoulder treatment
Frozen shoulder usually improves with conservative treatments and without surgery, but it can take over a year to fully recover. Our treatment for frozen shoulder focuses on pain management and restoring function.
Nonsurgical treatment
To treat frozen shoulder without surgery, your doctor may recommend the following treatments:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – Over-the-counter medications like ibuprofen and acetaminophen can help ease pain. Your doctor might also prescribe other anti-inflammatory or pain-relieving drugs.
- Steroid injections – This is when we inject a powerful anti-inflammatory medication, like cortisone, into the shoulder.
- Physical therapy – This helps restore motion. You’ll meet regularly with a physical therapist who specializes in shoulder conditions, and it will be important to perform approved exercises at home.
Often, our shoulder specialists will recommend a combination of these therapies to help your symptoms resolve faster.
Surgical treatment
Frozen shoulder won’t typically require surgery. In some instances, when conservative methods haven’t improved your symptoms, we might consider shoulder arthroscopy. With the help of an arthroscope, which is a thin tube with a light and a camera on it, your shoulder surgeon will cut through the tight areas in the shoulder.
Sometimes manual manipulation is also done with arthroscopy. During manual manipulation, your shoulder surgeon will force your shoulder to move, breaking up scar tissue or stretching the shoulder’s soft tissues. This often releases tightness and increases range of motion.