Frozen shoulder is an orthopedic condition characterized by pain and stiffness in the shoulder joint. The shoulder joint is surrounded by a capsule of connective tissue. If the capsule tightens and becomes thick, it can lead to frozen shoulder. Adhesions develop, and the level of synovial fluid can also decrease. The combinations of these factors cause the shoulder to become stiff and painful.
Causes
The reason some people develop frozen shoulder is not clear. Participating in certain activities does not seem to be a factor in developing the condition. According to the American Academy of Orthopaedic Surgeons, people with diabetes have an increased risk of developing frozen shoulder. Having your shoulder immobilized due to an injury is also consider a risk factor.
Symptoms
Frozen shoulder often starts slowly but can worsen over time. The main symptom of frozen shoulder is pain in the shoulder, which may radiate to the upper arm. Stiffness also develops. The pain can usually be described as achy or dull. Some people find that symptoms are worse at night when they are less active.
The course of the condition can involve a few different stages. Although it can vary, each stage can last months. In the first stage, the shoulder becomes painful and range of motion decreases. The second stage may involve less pain, but stiffness remains. In the third stage, range of motion may slowly improve. Symptoms usually resolve anywhere from six months to two years.
Diagnosis
The first step in diagnosing frozen shoulder involves a physical exam and medical history by a physician. During the exam, the doctor will move your shoulder to determine your range of motion. You will also be asked to move your shoulder on your own. This allows your doctor to determine both active and passive range of motion. Imaging studies may be performed, such as an x-ray to check for arthritis or an ultrasound to rule out a torn rotator cuff.
Although frozen shoulder can get better over time, it may take years for the condition to resolve. In the meantime, the condition can impact your day to day activities. Since shoulder range of motion is decreased, activities involving arm movement may be affected. In addition, the pain, which can last for months can also affect quality of life.
Self-help Treatment for Frozen Shoulder
Applying ice or heat can reduce symptoms of frozen shoulder. Although it can be uncomfortable, using your arm as much as you can, considering your range of motion is usually recommended. Non-steroidal anti-inflammatory medications, such as ibuprofen may help decrease pain.
Standard Clinical Treatments for Frozen Shoulder
If at home care does not resolve symptoms, there are additional options to consider. A steroid injection into the shoulder joint may reduce discomfort. Steroid shots don’t last forever and may have to be repeated in a few months.
Physical therapy may also be ordered to help improve range of motion. In rare cases, surgery may be used to remove adhesions in the shoulder joint.
Shoulder manipulation is also an option. During the procedure, which is usually performed under general anesthesia, the shoulder joint is manipulated and scar tissue is stretched. The procedure may improve range of motion and decrease tightening.
Sources
The University of Maryland Medical Center. Frozen Shoulder. http://umm.edu/health/medical/ency/articles/frozen-shoulder
American Academy of Orthopaedic Surgeons. Frozen Shoulder. http://orthoinfo.aaos.org/topic.cfm?topic=a00071
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