Skip to content

Dr. Khubaib back again! It’s time to discuss another condition we see in patients here at Montgomery Sports Medicine Center. Despite its name, Frozen Shoulder is something you can experience anytime of the year. 

What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a painful condition that causes stiffness and pain in the shoulder joint. Over time, the shoulder becomes very hard to move. 

After an initial period of worsening symptoms, usually occurring very slowly, frozen shoulder typically tends to get better. Full recovery, however, may take anywhere from 1 to 3 years.

What causes Frozen Shoulder? 

It is unclear why adhesive capsulitis develops in some people, but it’s more likely to happen after keeping your shoulder still for an extended period of time, such as after surgery. We do know that this condition occurs when the capsule of connective tissue around the shoulder joint thickens and tightens. This greatly restricts movement and in many cases, leads to less synovial fluid, which is used to lubricate the shoulder joint. 

A few factors may increase your risk for developing frozen shoulder:

    • Age and Sex: Frozen shoulder most commonly affects people between the ages of 40 and 60, and it occurs in women more often than men.
    • Diabetes: Frozen shoulder occurs much more often in people with diabetes, although the reason for this is not known. 
    • Other Diseases: People who have certain diseases appear more likely to develop frozen shoulder, including those who have an overactive thyroid (hyperthyroidism), an underactive thyroid (hypothyroidism), cardiovascular disease, and Parkinson’s disease.
    • Immobilization: Any shoulder injury or surgery that requires the need to keep your shoulder from moving or immobilized, 

Common Symptoms

Frozen Shoulder develops in 3 stages: 

  • The Freezing Stage: In this stage, your shoulder becomes stiff and loses range of motion. Movement causes pain and may worsen at night. This stage typically lasts between 6 weeks to 9 months
  • The Frozen Stage: In this stage, the pain from this condition may actually improve but the stiffness remains. Using it becomes more difficult, making it more difficult to complete daily tasks and activities. This state may last anywhere between 4 to 6 months.
  • The Thawing Stage: Any lasting pain may subside and your ability to move your shoulder slowly improves. Full range of motion and complete return to normal or close to normal strength typically takes anywhere from 6 months to 2 years.

How is Adhesive Capsulitis diagnosed?

Diagnosis requires a thorough history and physical examination with the additional aid of imaging modalities such as X-Rays, Diagnostic Ultrasound and MRI as needed. 

Treatment

As I mentioned before, frozen shoulder can resolve on its own, but spontaneous resolution takes an average of 2 years. Most people I know do not like pain and stiffness in their shoulder for such a long time! 

To accelerate and aid your recovery, there are several treatment options that can be tried. Such methods can include: 

  • At-home exercises 
  • Supervised physical therapy
  • Pain medications
  • Steroid injections

My personal favorite is a technique called glenohumeral dilation, in which, over a period of 3 weeks, in 3 different sessions, more and more fluid (usually a mixture of numbing medication and salt water) is injected into the shoulder joint to try and dilate and loosen up the stiff capsule of the frozen shoulder from inside. Right after the procedure, the shoulder is also manipulated by the provider or a physical therapist to try and physically break up the stiff scars while the shoulder is still numb from the injection. The exact treatment modality is individualized to the patient based on their symptom severity and preferences.  

Can you take any steps to prevent Frozen Shoulder?

There are certain factors that can be modified to help prevent frozen shoulder. If a person has diabetes, thyroid or similar diseases that have been associated with frozen shoulder, then having these diseases under good control can theoretically lower the chances of developing adhesive capsulitis. Physical therapy and early range of motion after injuries or surgeries of the shoulder would also prevent this condition. In general, an active lifestyle that incorporates exercises of all the joints in the body always helps.

Previous
Next
Back To Top