Frozen Shoulder

Do you have pain or stiffness in your shoulder? You may have frozen shoulder. This condition can hinder your ability to move your shoulders and carry out daily activities. Although it may go away on its own over time, treatment can help it heal more quickly.

At Banner Health, our team of orthopedic specialists is here to help you understand frozen shoulder and find the right treatment for your situation.

What is frozen shoulder?

Frozen shoulder, also called adhesive capsulitis, is a condition that causes stiffness, pain and loss of range of motion in your shoulder joint. The shoulder is a ball-and-socket joint made up of two bones: 

1. The humerus (upper arm bone) - the “ball”
2. The glenoid (part of the shoulder blade) - the “socket”

A joint capsule surrounds the shoulder joint. It is a flexible tissue that allows the shoulder to move smoothly. If you have frozen shoulder, this capsule becomes thick and tight, forming scar tissue called adhesions. This limits movement, causing the shoulder to feel “frozen.”

Symptoms of frozen shoulder?

Common frozen shoulder symptoms include:

• Stiffness and limited range of motion: You may find it hard to move your shoulder, especially when lifting or reaching.
• Pain: This can range from a dull ache to a sharp pain in the shoulder area. It may worsen at night or with movement.
• Discomfort in daily activities: Activities as simple as brushing your hair or reaching for objects overhead may become challenging. 

Stages of frozen shoulder

Frozen shoulder usually develops slowly in three stages:

• Freezing stage: This stage can last from six weeks to nine months. You may experience increasing pain and stiffness, making it difficult to move your shoulder.
• Frozen stage: During this stage, your shoulder may feel stiff but the pain may decrease. You will likely have a limited range of motion. This stage lasts four to twelve months.
• Thawing stage: In this stage, your shoulder will slowly begin to regain its normal range of motion. This process can take anywhere from six months to two years.

Causes and risk factors for frozen shoulder

The exact cause of a frozen shoulder is not always clear, but here are some of the most common causes and risk factors: 

• Age and gender: Frozen shoulder tends to happen more often in people between 40 and 60 and it’s slightly more common in women.
• Health conditions: Certain conditions, like diabetes, heart disease or thyroid disorders, can increase your chances of developing frozen shoulder. People with diabetes are more likely to experience the condition.
• Lack of movement: When you do not use your shoulder much, it can lead to stiffness and pain over time. Restricted movement may be due to a rotator cuff injury, a broken arm or recovery from surgery.

Diagnosing frozen shoulder

Your health care provider will ask you about your symptoms and do a physical exam. 

During the exam, they may ask you to move your arm in certain ways. This is to check how far you can move your arm (its range of motion) and for pain. They may also check your passive range of motion (when they move your arm for you). 

Your provider may order X-rays or MRI scans to rule out other conditions like arthritis.

What is the best way to treat frozen shoulder?

Several treatment options are available for frozen shoulder. The main goals are to increase motion and decrease pain. The right treatment plan depends on the severity of the injury, your symptoms and your overall health. 

Nonsurgical treatments

• Avoid heavy lifting: Give your shoulder time to heal by avoiding heavy activities.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or over-the-counter (OTC) pain relievers, such as ibuprofen or acetaminophen, can help reduce pain and inflammation. 
• Ice and heat therapy: Heat can relax the muscles, while cold packs can help reduce swelling and pain.
• Physical therapy: Physical therapy is a cornerstone of treatment. A physical therapist can guide you through exercises to improve your shoulder’s flexibility and strength. 
• Steroid injections: In some cases, your provider may recommend corticosteroid injections to reduce inflammation and pain. 
• Nerve stimulation: This treatment uses electrical pulses to help with pain and improve how your shoulder moves. It can make the nerves less sensitive, which helps physical therapy and other treatments work better.
• Stay active: Move your shoulder gently, even if it hurts a little. This can help prevent stiffness as you heal.

Surgical treatments

Most frozen shoulders get better within 12 to 18 months. If nonsurgical treatments do not relieve your symptoms, surgery may be an option. 

These are two main types of surgery for a frozen shoulder:

• Arthroscopic surgery: This minimally invasive procedure involves making small incisions (cuts) in the shoulder and using a camera to guide the surgery. An orthopedic surgeon will cut through the tight parts of your joint capsule, removing scar tissue to restore movement. 
• Manipulation under anesthesia: In this procedure, an orthopedic surgeon manipulates your shoulder while you are under anesthesia (put to sleep) to help break up scar tissue and improve your range of motion.   

Outlook for frozen shoulder

The good news is that a frozen shoulder usually improves with time. While the entire process can take several months to a couple of years, many people regain full or near-full use of their shoulder by the end. 

Preventing frozen shoulder

It’s not always possible to prevent a frozen shoulder, especially if it’s tied to a health condition. But there are things you can do to lower your risk:

• Keep moving after an injury or surgery: If you’ve had surgery or an injury like a rotator cuff tear, follow your provider’s advice for keeping your shoulder moving. Gentle exercises and stretches can help prevent stiffness.
• Stay active: Regularly moving and stretching can keep your shoulder flexible and reduce the chance of a frozen shoulder.
• Manage health conditions: If you have diabetes or another condition that raises your risk, work with your provider to manage it well.

Banner Health orthopedic care

If you’re experiencing symptoms of a frozen shoulder, it’s important to start treatment early. Schedule an appointment with a Banner Health orthopedic specialist today. We’re here to help you on your journey to recovery.