- Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
- The head of the upper arm bone fits into a shallow socket in your shoulder blade. Strong connective tissue, called the shoulder capsule, surrounds the joint.
- To help your shoulder move more easily, synovial fluid lubricates the shoulder capsule and the joint.
- Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes progressively harder to move.
- In frozen shoulder, the shoulder capsule thickens and becomes stiff and tight. Thick bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.
- The hallmark signs of this condition are severe pain and being unable to move your shoulder — either on your own or with the help of someone else. It develops in three stages:
- Freezing: In the "freezing" stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
- Frozen: Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the "frozen" stage, daily activities may be very difficult.
- Thawing: Shoulder motion slowly improves during the "thawing" stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.
- Not fully understood
- A few factors can put you at greater risk:
- Parkinson’s disease
- Cardiac disease
- After surgery
- After a fracture
- After other injuries to the shoulder
- Usually the pain is described as dull and achy to none at all
- Generally after a period of immobilization
- Inability to move the shoulder fully
Treatment for Frozen shoulder syndrome relies greatly on gaining the range of motion back in the shoulder. This is a progressive condition and it can take over one year to full recover. Physiotherapy is important to create exercises and stretching to meet these goals.
- Nonsteroidal anti-inflammatory medicines. Drugs like ibuprofen and naproxen reduce pain and swelling. Like any over the counter medication, please read and follow the label. If you have a history of stomach ulcers, bleeding ulcers or heart conditions, these medications might not be right for you. Consult your physician if you have any questions.
- Physiotherapy. Under the direction of an experienced physiotherapists, many patients do well by:
- Increasing Range of motion exercises and flexibility
- Massage and TENS
- Topical anti-inflammatories
- Compound Topical Creams
- Steroid (Depo-Medrol, Kenalog, Decadron)
- Blood (PRP – Platelet Rich Plasma)
- Usually the symptoms associated with frozen shoulder are self-limiting
- Under the direction of your surgeon, you may benefit from the following surgeries:
- Manipulation under anesthesia. You are put asleep and the surgeon will manipulate your arm to create more range of motion.
- Shoulder arthroscopy