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Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder (adhesive capsulitis) results in pain and stiffness in the shoulder. As the condition worsens, it can make the shoulder difficult to move. Frozen shoulder tends to improve on its own; however, a complete recovery may take as long as 3 years. This condition most commonly affects individuals between the ages 40 and 60, with women and people with diabetes at higher risk of developing it.

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What is Frozen Shoulder?

Frozen shoulder occurs when your shoulder capsule—the strong connective tissue surrounding the shoulder joint and rotator cuff tendons—thickens and tightens and stiffens the joint. Thick pieces of tissue develop, known as adhesions, and often there is less synovial fluid in the joint, which helps the shoulder move more easily.

Frozen shoulder most often results in severe pain and the inability to move the shoulder—independently or with the assistance of another person. The condition occurs in three stages:

  • Stage 1: Freezing – Your shoulder experiences worsening pain that results in inhibited shoulder movement over time. This stage commonly lasts from 6 weeks to 9 months.
  • Stage 2: Frozen – You experience less pain in your shoulder; however, the stiffness remains and makes routine activities difficult.
  • Stage 3: Thawing – Your shoulder mobility improves, with complete recovery typically taking between 6 months to 2 years.

What Causes Frozen Shoulder?

While the causes of frozen shoulder remain unknown, several risk factors exist. They include the following:

  • Shoulder Immobilization – Frozen shoulder may develop if the shoulder has been immobilized due to injury or surgery. For this reason, physical therapy programs encourage shoulder movement and exercises to prevent frozen shoulder from occurring.
  • Diabetes – People with diabetes are at increased risk of developing frozen shoulder. They also tend to experience greater stiffness and longer recovery periods.
  • Other Medical Problems – Cardiac disease, hypothyroidism, hyperthyroidism, and Parkinson’s disease also place people at higher risk of developing frozen shoulder.

What Are the Symptoms of Frozen Shoulder?

Frozen shoulder often results in dull or aching pain that worsens upon movement of the arm and during the early stages of the condition. The pain often radiates across the outside shoulder area and in some cases the upper arm.

How is Frozen Shoulder Evaluated?

To diagnose your condition, your doctor will perform a physical examination that focuses on evaluating your shoulder’s range of motion in all directions, checking to see if its movement is limited and accompanied by pain. This evaluation will focus on your passive range of motion—motion when assisted by someone else—and active range of motion—motion controlled by you without any assistance. Your doctor will compare these range of motion tests to help evaluate your condition. Patients with frozen exhibit limited motion both actively and passively.

Your doctor may order an X-ray, magnetic resonance imaging (MRI), or ultrasound to rule out other causes of your shoulder pain and stiffness.

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How is Frozen Shoulder Treated?

Frozen shoulder treatments include non-surgical and surgical options.

Non-surgical Treatment

In most cases, frozen shoulder can improve with simple, non-surgical treatments that focus on controlling pain and restoring motion.

  • Over-the-counter anti-inflammatory medications – Your doctor may recommend taking medications such as aspirin or ibuprofen to reduce pain and swelling.
  • Steroid injections – Your doctor may recommend more powerful anti-inflammatory medicine such as a cortisone injection, which is applied directly into the shoulder joint.
  • Hydrodilatation – Your doctor may recommend this procedure, which involves injecting sterile fluid into the shoulder joint to expand and stretch the strong connective tissue surrounding the joint.
  • Physical Therapy – Your doctor may recommend physical therapy to restore motion. This includes stretching and range of motion exercises.

Surgical Treatment

If frozen shoulder symptoms do not improve, your doctor may recommend surgery. Surgery aims to stretch and release the connective tissues surrounding the joint. The most common surgical procedures include shoulder arthroscopy and manipulation under anesthesia.

  • Shoulder arthroscopy – This procedure involves cutting through tight portions of the joint capsule using pencil-sized instruments inserted through small incisions in your shoulder.
  • Manipulation under anesthesia – In this procedure, your doctor puts you to sleep before forcing your shoulder to move. This stretches or tears the capsule and scar tissue, which lessens the tightening and improves your range of motion.

Often, both procedures are used to optimize clinical results and outcomes.

  • Recovery – After surgery, your doctor will prescribe physical therapy to sustain range of motion after surgery. Frozen shoulder surgery and recovery takes time and can range from 6 weeks to 3 months.

Schedule Your Appointment at Hand Center of Louisiana

If you believe you have frozen shoulder, contact us today to schedule a consultation with one of our highly trained physicians, who specialize in treating a variety of upper extremity conditions. Our qualified and experienced experts can diagnose your condition and determine the best treatment path for you.

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