Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move. Frozen shoulder occurs in about 2% of the general population and most commonly affects people between the ages of 40 and 60, occurs in women more often than men and can affect people with diabetes or other endocrine disorders.
In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue — called adhesions — develop. The hallmark sign of this condition is being unable to move your shoulder – either on your own or with the help of someone else. Pain from frozen shoulder is usually dull or aching. It is typically worse early in the course of the disease and when you move your arm.
It develops in three stages:
In the “freezing” or inflammatory stage, you develop more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.
Shoulder motion slowly im-proves during the “thawing” stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.
The causes of frozen shoulder are not fully understood. A few factors may put you more at risk for developing frozen shoulder. Frozen shoulder occurs much more often in people with dia-betes, affecting 10% to 20% of these individuals. Other medical problems associated with frozen shoulder include thyroid disease, Parkinson’s disease, and cardiac disease. Frozen shoulder can also develop after a shoulder has been immobilized due to surgery, a fracture, or other injury.
Frozen shoulder is a common problem and one with which The Orthopaedic Clinic doctors have much experience. Your doctor will examine your shoulder carefully to check for pain and limitations in motion.
Frozen shoulder generally gets better over time as it goes through the 3 phases, although it may take up to 2 years. The focus of treatment is to control pain and restore motion and strength through physical therapy.
More than 90% of patients improve with relatively simple treatments to control pain and re-store motion. These treatments include non-steroidal anti-inflammatory medicines, steroid injections in the shoulder joint and physical therapy.
If your symptoms are not relieved by these treatments and your progress has plateaued, your doctor may discuss surgery with you.
The goal of surgery for frozen shoulder is to release the stiffened joint capsule. The most common methods include shoulder arthroscopy and capsular release. In this procedure, your doctor will cut through tight portions of the joint capsule using pencil-sized instruments inserted through small incisions around your shoulder. In many cases, manipulation and arthroscopy are used in combination to obtain maximum results. Most patients have very good outcomes with these procedures.
After surgery, physical therapy is necessary to maintain the motion that was achieved with surgery. Long-term outcomes after surgery are generally good, with most patients having reduced or no pain and greatly improved range of motion.