Frozen Shoulder: Why the Joint Stiffens, How Long It Lasts and What Helps

What it involves

MedlinePlus describes frozen shoulder, also called adhesive capsulitis, as a condition in which the shoulder is painful and loses motion because of inflammation of the joint capsule. When the capsule is inflamed, the shoulder bones cannot move freely in the joint.

Who this is for

• Patients whose shoulder is painful and stiff and has slowly lost the ability to reach overhead or behind the back
• Patients with diabetes or thyroid problems who now have shoulder stiffness
• Patients recovering from a shoulder injury, shoulder surgery or other surgery who notice the joint tightening
• Patients who are not sure whether the problem is the shoulder, the neck or something else

What to expect

• Questions about when the pain began, which movements are limited and what you have already tried
• An exam of the shoulder, because MedlinePlus says the diagnosis is often made from the exam when you cannot rotate the shoulder
• An x-ray or other imaging only if needed to rule out a different problem, which would be done by referral
• A plan that may include pain relief, exercises, and joint injections at the Loxahatchee and West Palm Beach offices

How frozen shoulder develops

MedlinePlus says frozen shoulder can start with pain after no cause at all or after a minor injury. The pain may be severe enough to keep you from moving the arm, and the lack of movement then leads to stiffness and even less motion. Over time, movements such as reaching over the head or behind the back become impossible. The three main symptoms it lists are pain, decreased motion and stiffness. That slow loss of range is the feature that separates it from a one-time strain.

Who is more likely to get it

The encyclopedia says that in most cases there is no clear cause, and that women between 40 and 70 are most affected, though men can get it too. Listed risk factors include diabetes, thyroid problems, hormone changes such as menopause, shoulder injury, shoulder surgery, open heart surgery, recent breast surgery and cervical disk disease of the neck. Because diabetes and thyroid disease are on the list, the diabetes management page and the thyroid care page are relevant, and MedlinePlus says treating those risk factors matters too.

Telling it apart from other shoulder problems

Shoulder pain has many sources. A torn or irritated tendon is described in the tendinitis guide, inflammation of the cushioning sac is covered in the bursitis guide, and the general picture is in the shoulder pain guide. Pain that starts in the neck can also travel into the shoulder, which the neck pain guide explains. MedlinePlus says x-rays are used to make sure there is no other problem, such as arthritis or calcium deposits, and that MRI is usually not needed for frozen shoulder.

Treatment options MedlinePlus describes

According to MedlinePlus, pain is treated with nonsteroidal anti-inflammatory drugs and steroid injections, and steroid injections together with physical therapy can improve motion. It notes that physical therapy may be intense and needs to be done every day, and that it can take a few weeks to see progress. If non-surgical treatment does not work, surgery may be recommended to release scar tissue. The practice lists joint injections at the Loxahatchee and West Palm Beach offices; physical therapy and surgery are referrals.

How long recovery takes

The encyclopedia is candid about the timeline. Treatment with physical therapy and anti-inflammatory medicine often restores motion and function within a year, and complete recovery may take as long as nine months to a year. Even untreated, the shoulder may get better by itself in about two years, with little residual loss of motion, though other medical conditions can make the process longer. After surgery, therapy must continue for weeks or months, or the stiffness can return. Patience and consistency matter more here than any single visit.

When to be seen

MedlinePlus says that if you have shoulder pain and stiffness and think you have a frozen shoulder, you should contact your provider for evaluation, referral and treatment. It also says early treatment may help prevent stiffness, and advises contacting your provider if shoulder pain that limits range of motion lasts for an extended period. Sudden shoulder pain with chest pressure, shortness of breath or sweating is not a shoulder problem, and the chest pain guide explains why that calls for 911.

Sources

• MedlinePlus — Frozen shoulder