Frozen shoulder is a term for stiffness and pain in the shoulder joint that gradually develops and worsens over time. It is characterized by pain and loss of motion in shoulder joint. It is more common in older adults aged between 40 and 60 years and is more common in women than men.
A frozen shoulder has three stages:
- Freezing stage - pain is experienced when the shoulder has any sort of movement, and range of motion decreases
- Frozen stage - the pain begins to decrease, and the shoulder becomes stiffer, resulting in difficulty of performing daily activities
- Thawing stage - the pain continues to decrease and range of motion begins to slowly increase until there is close to the normal range of motion.
A frozen shoulder can last up to three years for the three stages. There are some non- surgical treatments available including physical therapy, cortisone injections or anti- inflammatory medications. One of the best prevention methods is to regularly perform exercises that maintain the shoulder range of motion.
If the non-surgical treatments do not the pain, the doctor may recommend surgical treatments which manually stretch the scar tissue in the shoulder or cut through the portions of the joint that are causing the pain.
Frozen shoulder is caused by inflammation of the ligaments holding the shoulder bones to each other. The shoulder capsule becomes thick, tight, and the stiff bands of tissue called adhesions may develop. The exact cause of a frozen shoulder has not yet been determined although it is more prevalent in patients that have had some form of arm injury which immobilizes the shoulder for a long period of time or a pre-existing disease, such as diabetes. Disease conditions such as hypothyroidism, hyperthyroidism, Parkinson’s disease and cardiac diseases are associated with frozen shoulder.
Frozen shoulder symptoms include:
- pain and stiffness in the shoulder joint
- limited movement in the shoulder joint
Frozen shoulder condition is diagnosed by medical examination in which the doctor evaluates shoulder movement and review of the pain and other presenting symptoms. The doctor will perform certain arm movements to check the active range of motion and maneuver the arm in different directions to check the passive range of motion. X-rays or MRI scans may be ordered to confirm the diagnosis and to rule out other causes of shoulder pain and stiffness.
Conservative Treatment options include:
- Non-steroidal anti-inflammatory drugs and steroid injections for pain
- Physical therapy to improve your range of motion
- Injections to stretch the joint capsule
- Heat may be applied to reduce pain
Shoulder arthroscopy may be recommended when the conservative treatment options are not effective. This is a minimally invasive surgery to remove scar tissue and adhesions in the shoulder. Following surgery physical therapy will be advised to bring full range of motion and strengthen the muscles.