Frozen shoulder, also known as adhesive capsulitis, is a pathological condition affecting the shoulder. It causes pain and stiffness in the shoulder joint, and over time makes the shoulder difficult to move. Approximately 2% of the population suffers from frozen shoulder syndrome. It is more prevalent in people ranging from 40 to 60 years old and in women more commonly than men.
Your shoulder is a ball-and-socket joint, composed of your upper arm bone (humerus), your shoulder blade (scapula) and your collarbone (clavicle). The head of your upper arm bone fits into a shallow socket in your shoulder blade and is surrounded by strong connective tissue, called the shoulder joint capsule. In a frozen shoulder, the shoulder capsule thickens and becomes tight, causing stiff bands of tissue to form, called adhesions. These adhesions begin to cause a loss of motion in your shoulder.
There are three separate phases of this condition:
1. Freezing: In the freezing stage you will gradually notice increasing pain. As your pain worsens, you begin to lose range of motion. This phase typically lasts from 6 weeks to 9 months.
2. Frozen: In the frozen stage, your pain may lessen; however, the stiffness will remain. This phase typically lasts 4-6 months and will make daily activities very challenging.
3. Thawing: In this stage, your shoulder motion begins to improve. A full return to normal strength and motion typically takes from 6 months to 2 years, depending on the severity of the condition.
What causes a frozen shoulder?
The causes of a frozen shoulder are not fully understood and there is no correlation to arm dominance or occupation. There are known contributing factors that may lead to frozen shoulder syndrome, including diabetes, prolonged immobilization due to a surgery or other injury, or as a result of other medical conditions including hypothyroidism, Parkinson’s disease and cardiac disease. Symptoms of a frozen shoulder include dull or aching pain and gradual loss of shoulder mobility.
How do you treat a frozen shoulder?
The focus of treatment is to control the pain and restore shoulder motion and strength through physical therapy. Therapy will include stretching or range of motion exercises as well as the use of heat occasionally to help loosen up the shoulder. Occasionally your physician may prescribe non-steroidal anti-inflammatory medicines to help reduce pain and swelling in addition to physical therapy.
If conservative treatment does not improve your symptoms, surgical interventions may be discussed with your physician. The goal of surgery is to stretch and release the stiffened joint capsule. The most common method includes manipulation under anesthesia in which you are put to sleep and your doctor will force your shoulder to move, causing the scar tissue to stretch or tear. Another common method is a shoulder arthroscopy, in which your doctor will cut through the tight portions of the joint capsule using a small instrument inserted through small incisions around your shoulder. Recovery following surgical intervention varies from 6 weeks to 3 months and will include physical therapy.