Frozen Shoulder

Written by Chitra Badii and Winnie Yu | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

Frozen shoulder is the common name for adhesive capsulitis, a shoulder condition that limits your range of motion. When the tissues in your shoulder joint become thicker and tighter, scar tissue develops over time. As a result, your shoulder joint does not have enough space to rotate properly. Common symptoms include swelling, pain, and stiffness. You are more likely to have the condition if you are between the ages of 40 and 60.

What Causes a Frozen Shoulder?

If you have a hormonal imbalance, diabetes, or a weakened immune system, you may be prone to joint inflammation. A long period of inactivity due to an injury, illness, or surgery also makes you more vulnerable to inflammation and adhesions. In serious cases, scar tissue may form severely limiting your range of motion. Usually, the condition takes two to nine months to develop.

Who Is at Risk for a Frozen Shoulder?

The condition is more likely to occur in middle age and is more common in women.

If you are diabetic, your risk for the condition is three times greater.

Others at risk include:

  • people who must wear a shoulder sling for a long period after an injury or surgery
  • stroke or surgery patients who must remain still for long periods of time
  • people with thyroid disorders

What Are the Symptoms of a Frozen Shoulder?

You become aware of a frozen shoulder when it begins to hurt. The pain then causes you to limit your movement. Moving the shoulder less and less increases its stiffness. Before long, you find that you cannot move your shoulder as you once did. Reaching for an item on a high shelf becomes difficult, if not impossible. At its most intense, you might not be able to do everyday tasks that involve shoulder movement.

How Is a Frozen Shoulder Diagnosed?

If you feel stiffness and pain in your shoulder, see your doctor. A physical exam will help to assess your range of motion. Your doctor will observe as you perform specific movements, such as touching your opposite shoulder with your hand.

A few tests may also be necessary. Your doctor might do an MRI to rule out a tear in your rotator cuff. X-rays may also be taken to check for arthritis. An arthrogram involves injecting dye into your shoulder joint so that the doctor can see its structure on the X-ray.

How Is a Frozen Shoulder Treated?

You can leave a frozen shoulder untreated. But the pain and stiffness can remain for up to three years. A combination of physical therapy, medication, surgery, and/or home care can speed up your recovery.

Physical Therapy

Physical therapy is the most common treatment for a frozen shoulder. The goal is to stretch your shoulder joint and strengthen its tendons. It can take anywhere from a few weeks to nine months to see progress. Generally, you must avoid movements that aggravate your condition, such as lifting or reaching up. If you do not see progress after six months of intense, daily exercises, speak to your doctor about other options.

Medications

To treat the pain and reduce your joint inflammation, your doctor may recommend anti-inflammatory medication (e.g., aspirin). A steroid injection into the shoulder joint may also be recommended.

Home Care

Placing an ice pack on your shoulder for 15 minutes at a time several times a day can help to decrease your shoulder pain. If you are working with a physical therapist, the exercises can be done at home. Your physical therapist will provide instructions on the types of exercises you must do, how often to do them, and when to push yourself harder. Most people with a frozen shoulder can improve their condition without surgery.

Surgery

If physical therapy does not improve your condition, surgery may be recommended. Your doctor will give you anesthesia and perform arthroscopic surgery. This type of surgery involves a small cut in your shoulder and the use of a camera (an arthroscope) to remove scar tissue or release it, increasing your range of motion. If your frozen shoulder resulted from an injury, surgery is usually more successful if it is performed within a few weeks of your injury.

Recovery from surgery typically requires at least one day in the hospital. Your stitches will most likely be removed after 10 days. Many patients have their full range of motion back within three months of surgery.

What Can Be Expected in the Long Term?

Most people recover within two years without treatment. Physical therapy and pain medications speed up this progress. If you have surgery, it is important to continue the therapy exercises in the following months so that the problem does not return. Surgery carries risks; some people still have pain or stiffness after surgery, or cannot endure the pain of physical therapy.

How Can a Frozen Shoulder Be Prevented?

Early treatment helps to keep the condition from getting worse. If you have diabetes, proper management of the condition can reduce your risk for a frozen shoulder.

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