You reach to tuck away a bag in an overhead compartment or to retrieve a book from a high shelf and suddenly you experience sharp pain. Before long any movement of your shoulder causes pain and you start losing range of motion. Eventually pain may subside, but you’re left with a shoulder that doesn’t want to work. What you may be experiencing is frozen shoulder syndrome. Here’s what you should know.
Frozen shoulder (also called adhesive capsulitis) is a common disorder that causes pain, stiffness, and loss of normal range of motion in the shoulder. The resulting condition can be serious, and tends to get worse with time if not treated. It typically affects people between the ages 40 to 60, and women more often than men.
Daniel P. Dare, M.D., Orthopedic Surgeon, of Merit Health Medical Group Orthopedics, shared with Well-Being the symptoms and stages of frozen shoulder, how it is diagnosed and how you can play a primary role in reversing its effects.
“We don’t fully understand the causes, but an inflammatory process is probably involved,” notes Dr. Dare. “Sometimes freezing occurs because the shoulder has been immobilized for a long time by injury, surgery, or illness. In many cases the cause is far less obvious. Fortunately, the shoulder can usually be unfrozen, though full recovery takes time – and lots of self-help.”
“The trademark symptoms include pain and progressive stiffness. At first, the shoulder is painful, but range of motion is still good. As the condition progresses, range of motion begins to decrease. By the time the shoulder eventually becomes ‘frozen,’ much of the pain has resolved, but you have difficulty moving your shoulder at all,” he explains.
Frozen shoulder is different from bursitis, another common shoulder ailment. With bursitis, pain and inflammation arise from repeated overhead movements like those involved in tennis, golf, and swimming. Pain often occurs during these activities, too. In comparison, the early pain of frozen shoulder is present even when the shoulder is at rest.
The good news is that frozen shoulder resolves on its own – but the entire cycle, from early symptoms to recovery, can last from nine months to two years.
Freezing, frozen, and thawing
Frozen shoulder has three stages: freezing, frozen, and thawing.
• Freezing. This is the slow, gradual buildup of pain and stiffness. Over time, you notice the shoulder lose more of its range of motion. During this period, the inflamed shoulder can be quite painful, and you may get steroid injections, spaced several weeks apart, to help ease the discomfort.
• Frozen. The pain begins to dissipate, but your range of motion is the most limited. You can do light chores and carry some weight on that side of your body, but it is still hard to lift your arm overhead. You often have difficulty with everyday movements, like dressing or reaching into your back pocket.
• Thawing. Stiffness goes away as the shoulder begins to heal. This is when you begin stretching exercises and formal therapy to help restore flexibility and range of motion. Typically, a physician or physical therapist teaches you the exercises, which you then do at home for several weeks or months.
“If you think you have a frozen shoulder or are developing one, see your physician or a shoulder expert for a physical exam,” advises Dare. “To assess your shoulder’s range of motion, he or she will ask you to perform various movements with your arm, such as reaching across your chest to touch the opposite shoulder or down your back to touch the opposite shoulder blade. He or she may take x-rays to make sure there’s no other underlying problem, such as arthritic changes or a dislocation. An MRI may be ordered to check for a rotator cuff tear.”
Treatment is focused on relieving pain and restoring the shoulder’s normal range of motion. Your physician may recommend an anti-inflammatory medication such as aspirin, ibuprofen (Motrin, Advil), or naproxen (Aleve, Anaprox). An ice pack or bag of frozen vegetables applied to the shoulder for 10 to 15 minutes several times a day can also help with pain. You may be given a corticosteroid injection into the shoulder joint or soft tissues. But the cornerstone of treatment is physical therapy, concentrating first on exercises that stretch the joint capsule, and later, on strengthening exercises. A physical therapist can show you how far to push yourself and can teach you the appropriate exercises. Once you’ve learned your limitations, you can practice most of your exercises on your own at home.
“If you have experienced the pain or reduction in range of motion in your shoulder, you should consult your doctor. He or she can confirm your condition and guide you through the healing process,” Dr. Dare adds. “The sooner you get help, the sooner you can hope to return to your previous level of activity without the pain and discomfort of frozen shoulder.
Daniel P. Dare, M.D., Orthopedic Surgeon, of Merit Health Medical Group Orthopedics received his Doctor o f Medicine degree from Louisiana State University Medical Center, New Orleans. He completed a rotating orthopedic internship at Charity Hospital, followed by an orthopedic residency at Tulane Medical Center and Associated Hospitals in New Orleans, as well as a trauma and total joint fellowship in Europe. He is board certified by the American Board of Orthopedic Surgery and is a Fellow of the American Academy of Orthopedic Surgeons and Arthroscopy Association of North America.