Frozen shoulder, or adhesive capsulitis, is a condition that causes stiffness and pain in the shoulder joint, and is not a sign of arthritis.
Signs and symptoms begin gradually, but the condition worsens over time, making it very difficult to move your shoulder. Frozen shoulder can resolve itself, but it takes up to three years. We can provide immediate treatment for quick healing.
The stages of frozen shoulder
Orthopedic specialists don’t fully understand the causes of frozen shoulder. There is no clear connection to arm dominance or occupation. We do know that frozen shoulder most commonly affects people between the ages of 40 and 60, and it occurs more often in women. In addition, people who have diabetes are at increased risk of developing frozen shoulder.
Frozen shoulder develops in three stages:
- Freezing. You have increasing pain, and as it worsens, your shoulder loses range of motion. Freezing typically lasts from six weeks to nine months.
- Frozen. Pain may improve during this stage, but the stiffness remains and daily activities may be very difficult. Frozen typically lasts from four to six months after the Freezing stage.
- Thawing. Shoulder motion slowly improves, and strength and motion can return to normal, or close to normal, after another six months to two years.
Frozen shoulder tends to hurt more at night due to pressure on the shoulder from sleeping positions. Placing a pillow between that arm and your body might help lessen the discomfort.
Non-surgical and surgical treatment options
Most of our patients with frozen shoulder improve with simple non-surgical treatments that control pain and restore motion:
- Corticosteroid injections. May help decrease pain and improve shoulder mobility, especially in the early stages of the process.
- Hydrodilatation or joint distension. Your orthopedic provider injects sterile water into the joint capsule to help stretch the tissue and make it easier to move the joint.
- Medications. Over-the-counter pain relievers such as aspirin and ibuprofen can help reduce pain and inflammation associated with frozen shoulder. Your doctor may prescribe stronger pain-relieving and anti-inflammatory drugs.
- Physical therapy. A physical therapist will teach you range-of-motion exercises to help recover mobility in your shoulder. Your commitment to physical therapy is key to its success.
If these do not work, your doctor may recommend surgery. This is typically offered during stage two, Frozen. The most common approaches include:
- Arthroscopic surgery. Your surgeon inserts pencil-sized instruments through small incisions around your shoulder to access the joint and remove scar tissue and adhesions.
- Manipulation under anesthesia. Your doctor moves your shoulder joint in different directions to help loosen the tightened tissue. You would receive a general anesthetic so you’ll be unconscious and feel no pain.
These procedures are usually successful, and we might use a combination of manipulation and arthroscopy to achieve the best results for your case.
Physical therapy typically works as a treatment, and if surgery was performed, physical therapy is necessary to maintain the motion that was achieved.
Stay committed to your therapy regimen, and you can expect a good outcome—recovery typically takes from six weeks to three months. Our orthopedic specialists are ready to help you get back to all the activities you enjoy.
Orthoinfo: American Academy of Orthopaedic Surgeons. Frozen Shoulder (https://orthoinfo.aaos.org/en/diseases–conditions/frozen-shoulder/)
National Center for Biotechnology Information (NCBI): National Library of Medicine. Frozen Shoulder (https://www.ncbi.nlm.nih.gov/books/NBK482162/)