As you go through perimenopause and menopause, your body undergoes many changes. While you may be familiar with common symptoms like hot flashes and night sweats, some other problems are less talked about — like shoulder pain and stiffness. Believe it or not, shoulder pain can be connected to the hormonal shifts that happen during these life stages.
If you’ve been dealing with nagging shoulder pain, you may be dealing with a condition called frozen shoulder. We spoke with Elizabeth Batterton, MD, a sports medicine physician with Banner – University Medicine, who shares why shifting hormones may be a trigger and ways you can find some relief.
What is frozen shoulder?
“Frozen shoulder or adhesive capsulitis is an inflammatory condition where the joint capsule in the shoulder becomes stiff,” Dr. Batterton said. “It leads to progressive pain and a decrease in shoulder range of motion.”
Frozen shoulder happens when the tissue around the joint capsule thickens and tightens.
Your shoulder capsule is a fluid-filled sac that lubricates the shoulder. When you have a frozen shoulder, the capsule hardens and thickens, making movement more difficult. This can make everyday activities — like reaching overhead or getting dressed — difficult.
“Some people may experience a dull ache in the shoulder or upper arm, but sometimes it can cause a sharp pain that radiates down the arm or your back muscles,” Dr. Batterton said.
The condition tends to develop in three stages:
- Freezing stage: The shoulder starts to hurt and movement becomes more limited. The pain usually gets worse over time. Lifting your arm out to the side or rotating it out can be difficult.
- Frozen stage: The pain might lessen but the shoulder becomes stiff, making it hard to move it at all. You might find it hard to do everyday activities, like washing your hair, lifting things overhead or driving.
- Thawing stage: The shoulder gradually improves and movement slowly returns to normal.
Depending on how severe your frozen shoulder is, it can take months to years to recover fully.
The link between menopause and frozen shoulder
Menopause is the stage of life when you no longer have a period. Your hormone levels – specifically estrogen and progesterone – decline. These low levels can cause many less-than-pleasant symptoms, like hot flashes and insomnia. However low levels of estrogen can also affect your joints.
“Estrogen plays a role in stimulating bone growth and maintaining joint and connective tissue health,” Dr. Batterton said. “As estrogen levels decline, the risk for inflammation and stiffness increases. This can contribute to conditions like frozen shoulder.”
New research supports the link between frozen shoulder and menopause. The study found that people who weren’t using hormone replacement therapy were twice as likely to develop frozen shoulder compared to those who were taking it.
Who is most at risk for frozen shoulder?
Frozen shoulder mostly affects people between the ages of 40 and 60 years, which just so happens to be when many people go through perimenopause and menopause.
While hormonal changes play a role, other factors can also increase your risk for the condition. These include a history of diabetes, shoulder injuries or certain health conditions, like thyroid disorders.
How to recognize frozen shoulder
If you’re experiencing shoulder pain, here are some clues that you may have frozen shoulder:
- Pain, especially at night: You may notice a dull or sharp ache in your shoulder, particularly when lying down or trying to sleep.
- Limited range of motion: Activities like reaching up or behind your back may become more difficult.
- Pain that worsens over time: Without treatment, the pain and stiffness can get worse, making daily tasks even harder.
Talk to your health care provider or a Banner Health specialist at the earliest signs of frozen shoulder.
“Early treatment can help improve pain and function and prevent a further reduction in your shoulder’s range of motion,” Dr. Batterton said. “I can also help reduce the significant impact it can have on activities and daily life.”
How to manage shoulder pain during menopause
If you’re experiencing frozen shoulder during menopause or perimenopause, your health care provider may recommend several things to help bring you relief and improve your quality of life:
Physical therapy
Physical therapy is one of the most effective treatments for frozen shoulder. A physical therapist can guide you through exercises that focus on improving flexibility and shoulder joint strength.
Here are a few stretches you can try at home:
- Pendulum swing: Lean forward with your knees slightly bent, letting your arms hang down loosely. Gently swing one arm in small circles clockwise. Make the same motion in the opposite direction. Repeat a few times.
- Doorway stretch: Stand in a doorway with your arm bent at a right angle, placing your hand on the doorframe. Gently lean forward to stretch the front of your shoulders. Hold for 15 seconds, then relax for 15. Repeat a few times.
- Finger walk: Place your fingers on the affected arm on a wall at waist height. Slowly walk your fingers up the wall as high as you can comfortably go without pain. Once you reach your limit, hold for a few seconds and then slowly walk your fingers back down. Repeat a few times.
Over-the-counter (OTC) medications
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help with pain and swelling. Follow dosage instructions.
Corticosteroid injections
If pain and stiffness continue despite physical therapy and medicine, steroid injections may provide relief. These injections are given by a health care provider and may help decrease pain and improve range of motion.
Hormone replacement therapy (HRT)
“Hormone replacement therapy may help to alleviate the symptoms of estrogen decline, including frozen shoulder,” Dr. Batteron said.
HRT can help protect against bone loss and support joint health. However, it’s not for everyone. Talk to your health care provider about the risks and benefits of HRT.
Hot and cold therapy
Both hot and cold therapy can help relieve shoulder pain. Cold packs can reduce swelling and numb sharp pain, while heat therapy can help relax tight muscles and increase blood flow to the area.
If you have swelling or sharp pain, try applying a cold pack for 15 to 20 minutes. If your shoulder is tight or stiff, a warm compress or heating pad can provide relief.
Healthy lifestyle
“Maintaining an active lifestyle and healthy weight, including a healthy diet and physical activity, can help reduce shoulder pain and stiffness,” Dr. Batterton said.
Proper posture
Poor posture, like slouching, can strain the shoulders. Try to keep your shoulders back when sitting or standing. When working at a computer or using your phone, make sure your shoulders are relaxed and your arms are at a comfortable angle.
Massage therapy
Massage can help relax tight muscles and improve circulation in your shoulder. A licensed massage therapist can work on the muscles around the shoulder to reduce tension and pain. You can also try to use a foam roller or massage ball at home to release tight spots.
Takeaway
Menopause is a time of many changes. Adding shoulder pain to the mix can make it even more challenging. If you think you have frozen shoulder, don’t wait. Early treatment can help reduce pain and improve your shoulder’s mobility. Talk to your health care provider or with a specialist at Banner Health.
