What is frozen shoulder?
Frozen shoulder, also called adhesive capsulitis, is when the tissues surrounding your shoulder joint, called the shoulder joint capsule, become inflamed. The inflammation causes discomfort, stiffness and a limited range of motion.
Although many conditions can cause shoulder pain and stiffness, frozen shoulder causes pain that lasts for more than three months, as the inflammation associated with frozen shoulder causes adhesions or scarring in the shoulder joint capsule.
Frozen shoulder stages
Frozen shoulder usually develops in three stages:
- Freezing stage: In this stage, the inflammation causes discomfort that slowly worsens and limits shoulder movement, reducing your ability to use it. Your pain may be worse at night. This stage can last from six weeks to nine months.
- Frozen stage: During the second stage, your pain may improve, but your shoulder still feels stiff and you still have a hard time using it. This stage can last as few as four and as many as 12 months.
- Thawing stage: This is the recovery stage of frozen shoulder when you gradually regain strength and full range of motion in your shoulder. Full recovery can take up to two years, but it may take longer for some people.
Fortunately, frozen shoulder often gets better without surgery. Physical therapy and stretching exercises can help most people manage symptoms.
Frozen shoulder symptoms
The main symptoms of frozen shoulder are pain and stiffness that make moving your shoulder or arm difficult.
The pain may appear suddenly, and you may feel it in the outer part of your shoulder or upper arm. For some people, discomfort can start as a dull ache and worsen when using the shoulder. The pain and stiffness can get worse over time until moving your shoulder becomes nearly impossible.
You may also develop neck pain with a frozen shoulder as your neck muscles try to compensate for your shoulder’s limited movement.
When to see a doctor
See your doctor if you experience shoulder pain for more than three months. Although frozen shoulder heals on its own over time, treating the condition in its early stages may help reduce its impact on your quality of life.
The more discomfort you feel, the less likely you are to use your shoulder, causing the shoulder capsule to get even thicker and tighter, leading to less mobility. If left untreated, your shoulder can become immobile or “frozen,” making everyday activities difficult.
What causes frozen shoulder?
Frozen shoulder occurs when inflammation causes the shoulder joint capsule to thicken and tighten. As a result, the joint becomes less flexible and can “freeze.” Scar tissue, called adhesions, can develop and impact the production of synovial fluid that keeps the shoulder joint lubricated. This makes shoulder movement and rotation difficult and painful.
Researchers do not know what causes this inflammation that leads to frozen shoulder. However, injuries that prevent you from moving your shoulder and other medical conditions are often associated with the condition.
Frozen shoulder risk factors
Frozen shoulder can happen to anyone, affecting about 5% of the population. Although doctors don’t know what causes frozen shoulder, certain factors can put you at greater risk.
- Age: Adults ages 40 to 60 are at greatest risk for frozen shoulder.
- Bursitis and rotator cuff tendonitis: These conditions cause inflammation that can lead to frozen shoulder.
- Diabetes: Frozen shoulder occurs in up to 20% of people with diabetes, who also take longer to recover than people without diabetes.
- Injury: Not using your shoulder can increase your risk of frozen shoulder, so injuries or surgeries that force you to keep your shoulder still are risk factors for the condition.
- Sex: Women are four times more likely than men to develop frozen shoulder.
- Other health conditions: In addition to diabetes, conditions that increase the risk of frozen shoulder include:
- Cancer
- Cardiovascular disease
- Complex regional pain syndrome
- Dupuytren’s contracture
- Hyperthyroidism (overactive thyroid)
- Hypothyroidism (underactive thyroid)
- Parkinson’s disease
- Stroke
How to diagnose frozen shoulder
There’s no specific test used to diagnose frozen shoulder. The condition can usually be diagnosed by a provider based on a physical exam. Your doctor will ask about symptoms and examine your shoulder. You may need imaging to help your doctor rule out other conditions, but imaging tests can’t diagnose a frozen shoulder definitively.
Frozen shoulder treatment
Most cases of frozen shoulder benefit from medications and physical therapy and do not need surgery. Your doctor will recommend a treatment plan based on the results of your physical exam and the stage at which your frozen shoulder was diagnosed. If your frozen shoulder is related to an underlying condition, your doctor will work with you to help treat or manage the condition.
Find specialized care for frozen shoulder
At Baylor Scott & White, we have multiple locations across North and Central Texas to provide you with access to expert care. Whether you're seeking diagnostic testing, treatment options or ongoing support for frozen shoulder, our teams are here to help you.
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