Frozen Shoulder Explained

Frozen Shoulder Explained

What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness, pain, and limited movement in the shoulder joint. It develops when the connective tissue surrounding the shoulder joint thickens and tightens, restricting movement. It typically progresses through three stages: the freezing phase, the frozen phase, and the thawing phase.

Classification of Frozen Shoulder

Frozen shoulder is classified as a condition affecting the musculoskeletal system. It is not caused by trauma but develops gradually, often without a clear triggering event.

Frozen Shoulder Health Signs and Symptoms

• Pain: A dull or aching pain, often felt in the outer shoulder and sometimes extending to the upper arm.
• Stiffness: Difficulty moving the shoulder, especially when trying to lift the arm.
• Reduced Range of Motion: Limited ability to move the shoulder in all directions.
• Sleep Disruption: Pain that worsens at night can make it difficult to sleep.
• Gradual Onset: Symptoms typically start slowly and worsen over time.

Types of Frozen Shoulder

1. Primary (Idiopathic) Frozen Shoulder: Develops without any known cause, often in people between 40 and 60 years of age.
2. Secondary Frozen Shoulder: Occurs after an injury or surgery, or in people with certain medical conditions, such as diabetes or thyroid disorders.

How to Test for Frozen Shoulder

There is no specific blood test for frozen shoulder, but diagnosis is based on:

• Physical Examination: A healthcare provider will assess your shoulder’s range of motion and check for pain and stiffness.
• Imaging Tests: X-rays or MRIs may be used to rule out other conditions, such as arthritis, and to examine the shoulder joint for abnormalities.

What Type of Health Professionals Treat Frozen Shoulder?

• Orthopedic Specialists: Doctors who specialize in musculoskeletal conditions, including frozen shoulder.
• Physical Therapists: Play a key role in the rehabilitation process to restore movement.
• Primary Care Physicians: Can diagnose and manage initial symptoms, referring to specialists if needed.
• Rheumatologists: May be involved if an underlying condition like arthritis is suspected.

How to Prepare to See a Health Specialist

• Keep a Symptom Diary: Track when symptoms started, how they’ve progressed, and what triggers pain.
• Bring Medical History: Include details about past shoulder injuries, surgeries, or medical conditions like diabetes or thyroid issues.
• List Current Medications: Note any medications or supplements you are taking, especially if you are managing a chronic illness.
• Prepare Questions: Be ready to discuss your symptoms and ask relevant questions (see next section).

What Questions to Ask a Doctor?

• What is causing my shoulder pain and stiffness?
• What stage of frozen shoulder am I in?
• What treatments do you recommend for my condition?
• How long will it take to recover from frozen shoulder?
• Are there exercises I should avoid?
• How often will I need physical therapy?
• Are medications necessary for managing pain or inflammation?
• Could other conditions (e.g., diabetes) be contributing to my frozen shoulder?
• How can I prevent frozen shoulder in the future?
• Are there any risks of permanent loss of motion?

What Types of Treatments Exist?

• Medications:
  • Over-the-counter pain relievers such as ibuprofen or acetaminophen.
  • Prescription anti-inflammatory drugs or corticosteroid injections to reduce pain and inflammation.
• Physical Therapy:
  • Stretching and strengthening exercises to improve range of motion.
  • Gentle manual therapy to help loosen tight shoulder tissues.
• Surgery: In rare cases, surgical intervention such as shoulder manipulation or arthroscopic surgery may be recommended if physical therapy and medications fail.
• Hydrodilatation: An injection of sterile fluid into the joint to expand the shoulder capsule and improve motion.
• Steroid Injections: Corticosteroid injections into the shoulder joint to reduce pain and swelling.

How to Monitor Frozen Shoulder

• Range of Motion: Monitor your ability to move your shoulder, especially when lifting your arm or rotating the joint.
• Pain Levels: Keep track of when pain increases or decreases, and note any triggers.
• Physical Therapy Progress: Follow your therapist’s guidelines and track progress over time to gauge improvements.
• Home Monitoring Tools: Use a simple range of motion chart to track shoulder flexibility at home, or try shoulder exercises with resistance bands to measure strength improvement.

How to Manage Frozen Shoulder

• Exercise: Gentle, regular stretching and range-of-motion exercises, as guided by a physical therapist, are critical.
• Heat and Ice: Apply heat or ice packs to the shoulder to relieve pain and stiffness.
• Activity Modification: Avoid activities that involve repetitive shoulder movements or overhead lifting.
• Pain Management: Use over-the-counter pain relievers and apply heat or ice as needed to control pain.

Nutrition Dos and Don’ts

• Dos:
  • Include anti-inflammatory foods like fish rich in omega-3 fatty acids, nuts, seeds, fruits, and vegetables in your diet.
  • Stay hydrated, as dehydration can exacerbate muscle and joint pain.
  • Ensure you are getting enough calcium and vitamin D to support joint health.
• Don’ts:
  • Avoid processed foods and foods high in sugar, which can contribute to inflammation.
  • Limit alcohol and caffeine, as they can interfere with muscle recovery and increase dehydration.

Lifestyle Dos and Don’ts

• Dos:
  • Stick to your physical therapy regimen to maintain range of motion and flexibility.
  • Rest your shoulder, especially during the freezing phase, but continue gentle movement to avoid stiffness.
  • Get adequate sleep to help your body recover and manage pain more effectively.
• Don’ts:
  • Avoid overusing or forcing movement in the shoulder, which can worsen the condition.
  • Don’t neglect physical therapy once you enter the frozen or thawing phases, as consistent therapy is key to recovery.

Emergency Situations

Frozen shoulder itself does not typically cause medical emergencies, but if you experience any of the following, seek immediate care:

• Sudden, severe shoulder pain: If pain becomes unbearable or is accompanied by sudden swelling or deformity, it could indicate an injury.
• Inability to move the arm after a fall or injury: This could be a sign of a dislocation or fracture.
• Signs of infection: Fever, redness, warmth, and swelling in the shoulder joint could suggest an infection, particularly if you’ve had a recent injection or surgery.

What to do:

• If the pain is severe or comes on suddenly, apply ice and immobilize the shoulder until you can see a doctor.
• In case of suspected infection or injury, seek medical attention immediately.

Questions Related to Frozen Shoulder 

1. What causes frozen shoulder?

   • The exact cause is unknown, but it may result from prolonged immobility after injury or surgery, or due to conditions like diabetes or thyroid disorders.

2. How long does frozen shoulder last?

   • It can last from several months to three years, depending on the stage and treatment.

3. Can frozen shoulder go away on its own?

   • In some cases, it may resolve without treatment, but physical therapy significantly speeds up recovery.

4. Is frozen shoulder more common in certain people?

   • It is more common in people aged 40-60, women, and those with diabetes or thyroid disorders.

5. Can frozen shoulder affect both shoulders?

   • Yes, but usually not at the same time. It may occur in one shoulder and then develop in the other after recovery.

6. What is the best exercise for frozen shoulder?

   • Gentle range-of-motion exercises like the pendulum stretch and cross-body arm stretches are often recommended.

7. Can I prevent frozen shoulder?

   • Staying active, managing chronic conditions like diabetes, and maintaining good shoulder mobility can help reduce the risk.

8. How is frozen shoulder diagnosed?

   • A doctor will perform a physical exam and may order X-rays or an MRI to rule out other conditions.

9. Is surgery necessary for frozen shoulder?

   • Surgery is typically a last resort, used only if non-surgical treatments like physical therapy and injections fail.

10. Does frozen shoulder cause permanent damage?

• Most people recover full or near-full shoulder function, but untreated cases may result in some permanent loss of motion.