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What is Frozen Shoulder?

by Jaydee Vykoukal, PT, DPT November 24, 2020 0 Comments

frozen shoulder

What is a frozen shoulder? About 2% of the general population suffers from a frozen shoulder. It is most common in people aged 40 to 60. This condition occurs when the soft tissue around your shoulder becomes inflamed (usually from a shoulder injury) and then becomes progressively immobile with time. It is important to catch any problems early to avoid long-term issues. How do you get a frozen shoulder? Read on to learn the answer, along with effective treatment options to help you heal.  

What is a Frozen Shoulder?

The shoulder is a ball-and-socket joint and has three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). The head of the humerus fits perfectly into a socket of your scapula. A strong connective tissue, known as the shoulder capsule, surrounds the joint. It’s what gives your shoulder stability while also allowing it to move the way it needs to. 

To move the shoulder easily, there should be enough synovial fluid to constantly lubricate the joint and the shoulder capsule. Shoulder tissue health and extensibility are also crucial for a balance of movement and stability. Once the shoulder capsule becomes tight, stiff bands of tissue can develop, which cause a frozen shoulder, also known as adhesive capsulitis.

Frozen Shoulder Stages

Frozen shoulder develops slowly, in three distinct phases. Each stage of frozen shoulder can last for several months.

1. Freezing

During the first stage, the pain comes on gradually and slowly limits shoulder movement. You may not notice anything until it is too late. In just a few months, the discomfort may become severe enough to affect your sleep and daily routine. The “freezing” phase may last from six weeks to nine months.

2. Frozen

The symptoms may improve during the “frozen” phase, but the stiffness remains. From four to six months, performing everyday activities can be very complicated. Restriction of shoulder movement may last for up to a year.

3. Thawing

The final stage is referred to as the “thawing” phase. Shoulder mobility gradually improves. Patients require six months to two years to regain normal shoulder mobility and strength.

Frozen Shoulder Causes

The medical community still does not fully understand the underlying causes of frozen shoulder. In fact, there is no clear connection to job type or arm dominance. However, these factors are known to increase the risk of developing frozen shoulder:

  • Immobilization

    Frozen shoulder may occur when the shoulder has been immobilized for a long period, whether because of a fracture, surgery, or other serious injury that keeps you from moving your arm normally.

  • Diabetes

    Studies have shown that 10% to 20% of people with diabetes have suffered from frozen shoulder.

  • Other Health Problems

    Other chronic diseases linked to frozen shoulder include cardiac disease, Parkinson’s disease, hyperthyroidism, and hypothyroidism.

Injuries that may cause frozen shoulder include shoulder impingement and rotator cuff tears.

Frozen Shoulder Symptoms

Frozen shoulder can affect one or both shoulders. Knowing the signs is important and can help your doctor narrow the long list of possible problems. Listed below are the most common symptoms of frozen shoulder.

  • Swelling and tenderness touch
  • Generalized shoulder pain
  • Difficulty sleeping on your side
  • Unable to quickly reach for something
  • Pain worsens at night, disrupting sleep
  • Stiffness that does not go away
  • Loss of shoulder function and range of motion

Frozen Shoulder Diagnosis

With a 360-degree range of motion, the shoulder has one of the greatest risks of injury of all joints. Early and proper diagnosis will help prevent long-term discomfort in your shoulder joint.

  • Medical History and Physical Examination

    Your doctor will ask about your symptoms, general health, and medical history. Your shoulders will be examined thoroughly, looking for pain with motion and limited mobility.

    The range of motion your shoulder has when moving independently is called “active range of motion.” Your healthcare provider will compare this to the “passive range of motion,” when somebody else moves your shoulder.

  • X-Ray

    When necessary, an X-ray shows dense structures like bones and can help your doctor determine whether your symptoms are from other serious conditions, such as a broken bone or arthritis.

  • MRI Scan

    An MRI scan produces better images, particularly of soft tissues, which will help your doctor identify other causes of pain and stiffness. Other potential issues to rule out might include a  rotator cuff tear or bursitis.

Frozen Shoulder Recovery Time

There is a lot of controversy over the best way to treat and heal a frozen shoulder, the biggest factor being time. While recovering, it is most important to manage pain symptoms and prevent further injury. When the thawing stage occurs results can be maximized.

Conservative treatment and comfort measures are the primary recommended treatment for frozen shoulder. Pain modalities, ibuprofen, injections, and gentle stretching and exercise are all possible options that you can discuss with your doctor or physical therapist.

Frozen Shoulder Conservative Treatments

Recovery Time with Surgery

Arthroscopic surgery is typically a last ditch effort for frozen shoulder and there are two major complications that can hinder healing time. Fracture of the shaft or proximal humerus and traction lesion of the brachial plexus. Physical therapy is necessary to maintain the range of motion that was achieved by surgical repair and avoid scar tissue.

The recovery time may vary, usually from six weeks to three months. The pain and stiffness will subside eventually, but full recovery typically requires one and a half to two years.

Prevent Recurring Frozen Shoulder

Recovering from a frozen shoulder can feel like a daunting process. It will force you to slow down and take care of your shoulder as it heals. Don’t forget to stay tuned into your body’s symptoms. Always follow your doctor’s and physical therapist’s orders, and schedule follow-up visits. Your commitment to recovery is the key factor in returning to your lifestyle and all the activities you enjoy. 

Sources:

https://beta.nhs.uk/conditions/f rozen-sho ulder

http://www.orthop.washington.edu/?q=patient-care/articles/shoulder/home-exercises-for-the-stiff-or-frozen-shoulder.html

https://physioworks.com.au/treatments-1/soft-tissue-massage

Frozen Shoulder Products

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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