Frozen shoulder, or adhesive capsulitis is a common malady that strikes about 200,000 Americans every year. Most of its victims are women, and most of them are middle-aged. People who have diabetes are also very prone to frozen shoulder.
Doctors don’t really know why people get frozen shoulder, but they suspect that inflammation has something to do with it. The person feels a dull ache in their affected shoulder and pain in the muscles that enclose the upper arm bone that radiates down the upper arm. Some people find that their pain is worse during the night. Sometimes the pain interferes with sleep.
Even without treatment, a case of frozen shoulder usually goes away within two years. However, without treatment, the patient may not be as free of discomfort, and they may not completely regain the normal range of motion in their shoulder.
What is Frozen Shoulder?
The muscles, bones, tendons, ligaments, and other structures in the shoulder allow it a wide range of movement but also subjects it to trauma. Frozen shoulder happens when the capsule protecting a structure called the glenohumeral joint stiffens up and contracts for some reason. Scar tissue called adhesions can also develop between the capsule and the ball that forms the head of the humerus bone, the long arm bone that runs from the shoulder to the elbow. Trying to keep the shoulder immobile to avoid pain makes the condition worse. On top of this, the capsule may lose some of the fluid that keeps it lubricated. This results in further stiffness. The shoulder pain and stiffness that results from frozen shoulder can make it impossible to perform normal tasks, at least with the affected arm, and the condition can worsen if it’s not treated. Frozen shoulder doesn’t happen all at once but develops over months. It’s important for a patient to see their doctor if they believe that the condition is developing.
How Do You Get Frozen Shoulder?
Frozen shoulder may be a complication of another type of injury to the shoulder such as shoulder tendonitis or bursitis. In the first case, the tendons that connect the muscles to the bone are inflamed. In the second case, the little fluid-filled sacs that lubricate the area become inflamed. Other people contract frozen shoulder because they couldn’t move their shoulder for a long time. This could be due to surgery. Ironically, the surgery may have been done to correct another shoulder injury such as a rotator cuff injury or impingement syndrome.
Other people get frozen shoulder after or during an illness such as hypo- or hyperthyroidism or Parkinson's disease. Frozen shoulder can be the result of a stroke that affects that area of the body or a broken bone or dislocation of the shoulder joint. Some people seem to get frozen shoulder for no reason.
Therapy and Treatment
Fortunately, there are many ways to successfully treat frozen shoulder even though it may take a long time for the shoulder to regain its normal range of motion without discomfort. Physiotherapists use techniques such as electrotherapy to reduce inflammation and soft tissue massage to release the muscles. Doctors also prescribe NSAIDs or give injections to ease the pain.
The treatment will depend on how much the motion of the shoulder has been affected, and the health professional can assess this by having the patient move their shoulder. The patient may also have an imaging test done to make sure there are no other injuries in their shoulder such as a torn rotator cuff. Exercises that can help a person recover from frozen shoulder include:
- Pec stretches
- Sleeper stretches
- Lower limb weights that don’t involve the shoulder
- Upper limb weights for the uninjured arm
As the shoulder improves, the patient can graduate to:
- Resistance exercises such a shoulder isometrics
- Scapular clocks
- Lawnmowers
- Box step-ups
- Ball handling
- Dumbbell bench presses
- Low impact running
If there is a lot of scar tissue in the area, surgery may be used to correct frozen shoulder.