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 to three years.
Your risk of developing frozen shoulder increases if you're recovering from a medical condition or procedure that prevents you from moving your arm — such as a stroke or a mastectomy. Frozen shoulder can also happen because you have diabetes – it's still unclear why this is.
People 40 and older, particularly women, are more likely to have frozen shoulder and people who've had prolonged immobility or reduced mobility of the shoulder are at higher risk of developing frozen shoulder. Immobility may be the result of many factors, including:
- Rotator cuff injury
- Broken arm
- Recovery from surgery
However, it's generally not clear why people get a frozen shoulder.
Diagnosis and Symptoms
Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months.
- Freezing stage. Any movement of your shoulder causes pain, 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 using it becomes more difficult.
- Thawing stage. The range of motion in your shoulder begins to improve.
For some people, the pain worsens at night, sometimes disrupting sleep.
Other tests that may help your doctor rule out other causes of stiffness and pain include:
- X-rays. Dense structures, such as bone, show up clearly on x-rays. X-rays may show other problems in your shoulder, such as arthritis.
- Magnetic resonance imaging (MRI) and ultrasound. These studies can create better images of problems with soft tissues, such as a torn rotator cuff.
More than 90% of patients improve with relatively simple treatments to control pain and restore motion.
Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and swelling.
Steroid injections. Cortisone is a powerful anti-inflammatory medicine that is injected directly into your shoulder joint.
Stretching and Exercise
Stretching or range of motion exercises are used for the rehabilitation of the shoulder.
Sometimes heat is used to help loosen the shoulder up before the stretching exercises.
Below are examples of some of the exercises that might be recommended.
- External rotation — passive stretch. Stand in a doorway and bend your affected arm 90 degrees to reach the doorjamb. Keep your hand in place and rotate your body as shown in the illustration. Hold for 30 seconds. Relax and repeat.
- Forward flexion — supine position. Lie on your back with your legs straight. Use your unaffected arm to lift your affected arm overhead until you feel a gentle stretch. Hold for 15 seconds and slowly lower to start position. Relax and repeat.
- Crossover arm stretch - Gently pull one arm across your chest just below your chin as far as possible without causing pain. Hold for 30 seconds. Relax and repeat.
Keep performing these exercises until you are able to freely move the arm through all range of motions without any pain.