Frozen shoulder Health Article

Definition

Frozen shoulder is when the shoulder is painful and cannot move normally because of inflammation.

Alternative Names

Adhesive capsulitis

Causes, incidence, and risk factors

The joint capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint.

Most of the time there is no cause for the inflammation. However, inflammation may be caused by:

• Cervical disk disease of the neck
• Diabetes
• Shoulder trauma
• Shoulder surgery
• Open heart surgery
• Hyperthyroidism

Symptoms

The main symptoms are:

• Decreased motion of the shoulder
• Pain
• Stiffness

Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. The lack of movement leads to stiffness and decreased motion. Eventually you cannot perform activities such as reaching over your head.

Signs and tests

The health care provider will make the diagnosis based on your symptoms and an examination of your shoulder.

You may have x-rays of the shoulder to make sure there is no other problem, such as arthritis. Sometimes an MRI exam may show inflammation, but there are no specific findings that diagnose frozen shoulder.

Treatment

Pain is treated with nonsteroidal anti-inflammatory medications (NSAIDs) and steroid injections. Steroid injections along with physical therapy can significantly improve motion. It can take as long as 6 - 9 months to see improvement. The physical therapy is intense and needs to be done every day.

Any risk factors for frozen shoulder may also need to be treated.

Surgery is recommended if therapy is not successful. Your health care provider will release the scar tissue by bringing the shoulder through a full range of motion. This procedure is done under anesthesia.

Arthroscopic surgery can be used to cut the tight ligaments and remove the scar tissue from the shoulder. Some surgeons may use repeated pain blocks after surgery so you can participate in physical therapy.