Definition
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one or two years.
Your risk of developing frozen shoulder increases if you’re recovering from a medical condition or procedure that affects the mobility of your arm — such as a stroke or a mastectomy.
Treatment for frozen shoulder involves stretching exercises and, sometimes, the injection of corticosteroids and numbing medications into the joint capsule. In a small percentage of cases, surgery may be needed to loosen the joint capsule so that it can move more freely.
Symptoms
Frozen shoulder typically develops slowly, and in three stages. Each of these stages can last a number of months.
- Painful stage. During this stage, pain occurs with any movement of your shoulder, and your shoulder’s range of motion starts to become limited.
- Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and your range of motion decreases notably.
- Thawing stage. During the thawing stage, the range of motion in your shoulder begins to improve.
For some people, the pain worsens at night, sometimes disrupting normal sleep patterns
Causes
The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.
Doctors aren’t sure why this happens to some people and not to others, although it’s more likely to occur in people who have recently experienced prolonged immobilization of their shoulder, such as after surgery or an arm fracture.
Risk factors
Although the exact cause is unknown, certain factors may increase your risk of developing frozen shoulder.
Age and sex
People 40 and older are more likely to experience frozen shoulder. Most of the people who develop the condition are women.
Immobility or reduced mobility
People who have experienced prolonged immobility or reduced mobility of their shoulder are at higher risk of developing frozen shoulder. Immobility may be the result of many factors, including:
- Rotator cuff injury
- Broken arm
- Stroke
- Recovery from surgery
Systemic diseases
People who have certain medical problems appear to be predisposed to develop frozen shoulder. Examples include:
- Diabetes
- Overactive thyroid (hyperthyroidism)
- Underactive thyroid (hypothyroidism)
- Cardiovascular disease
- Tuberculosis
- Parkinson’s disease
How is it treated?
Treatment for frozen shoulder usually starts with nonsteroidal anti-inflammatory drugs (NSAIDs) and application of heat to the affected area, followed by gentle stretching. Ice and medicines (including corticosteroid injections) may also be used to reduce pain and swelling. And physical therapy can help increase your range of motion. A frozen shoulder can take a year or more to get better.
If treatment is not helping, surgery is sometimes done to loosen some of the tight tissues around the shoulder. Two surgeries are often done. In one surgery, called manipulation under anesthesia, you are put to sleepand then your arm is moved into positions that stretch the tight tissue. The other surgery uses an arthroscope to cut through tight tissues and scar tissue. These surgeries can both be done at the same time.