The Stiff or “Frozen” Shoulder

Although not related to the cold weather of winter, I thought it would be helpful to discuss a common shoulder problem known as “adhesive capsulitis” or “frozen shoulder.” Frozen shoulder most often affects people between the ages of 40 and 60 and is more common in women. Normal shoulder function depends on pain-free, fluid, and unrestricted motion of the joint. As such, patients afflicted with frozen shoulder can be significantly debilitated with everyday activities such as work, recreation, and sleep impacted. Though the cause of frozen shoulder is not clearly understood, there are certain known risk factors. Below we’ll delve into the symptoms, risk factors, and possible treatment options for frozen shoulder.

Symptoms

Frozen shoulder results from thickening of the tissue that surrounds and stabilizes the shoulder joint making it tight and difficult to move. The tissue may also become significantly inflamed and or irritated making motion of the shoulder painful. Frozen shoulder often follows three predictable phases each with slightly different symptoms as outlined below.

•A dull ache and onset of worsening pain during the first stage (“freezing phase”).

•A slight reduction in pain during the second stage (“frozen phase”) where the shoulder becomes significantly stiff with very little mobility in the shoulder.

•A slow return to normal and pain-free motion in the shoulder in the final stage (thawing phase).

Each phase may last from a few weeks to several months with the complete course of the condition lasting for 18-24 months.

Risk Factors

There are certain factors that can make a person more likely to develop frozen shoulder. These includes:

•Diabetes

•Thyroid dysfunction (hypo- or hyperthyroidism)

•Parkinson’s disease

•Cardiac disease

•Immobility. If a person becomes immobile for a period of time, usually do to a surgical procedure or injury, then their risk for developing frozen shoulder increases.

Treatment

The most common treatment for frozen shoulder is non-surgical with the aim to reduce irritation and pain in the shoulder and then slowly regain full motion through gentle stretching exercises.

Common treatment methods include:

•Anti-inflammatory medicine

•Steroid injections

•Physical Therapy – both home stretching and office-based treatments

In rare cases where non-surgical treatment fails to resolve the condition, surgery is generally very successful at restoring full shoulder function. The procedure is done athroscopically, or through tiny incisions, and involves gentle manipulation of the shoulder with the patient anesthetized as well as release or cutting of any tight scar tissue around the shoulder.