A frozen shoulder is a common condition. It affects about 3% of the population at some point in their life. Although the condition is more frequently seen in women, it can also affect men. People in the 40 to 60 years age group are at the highest risk of developing a frozen shoulder. The exact cause is unknown although some people with certain systemic diseases are more likely to develop a frozen shoulder. Often it starts when there is an injury to the arm and shoulder which causes immobility at the shoulder joint. However, not every person with a frozen shoulder will have a history of an arm or shoulder injury.

The main symptoms reported in frozen shoulder is shoulder pain and limited range of motion. The pain is usually one the earliest symptoms but as the condition progresses, the pain gradually eases while the stiffness of the joint increases. Most people with a frozen shoulder report that the pain tends to worsen in the evenings and when attempting to move the arm. However, immobilizing the shoulder joint is not advisable. In fact the arms need to keep working and stretching exercise should be conducted daily.

There is no known cure for a frozen shoulder. However, it can be treated. The treatment is aimed at managing the symptoms until the condition settles on its own. Always follow your doctor’s instructions closely. Treatment requires medication, drugs and sometimes even surgery. However, the majority of frozen shoulder cases never need surgery.

Nevertheless, you should always speak to a doctor about condition. Attempting to manage it at home with over-the-counter drugs can be dangerous for some patients. Sometimes the symptoms of what seems to be a frozen shoulder may have nothing to do with it but it could be some underlying other disease which could even be fatal if not treated promptly.

Shoulder bones

Medical Name Is Adhesive Capsulitis

The medical term for a frozen shoulder is adhesive capsulitis. The shoulder is made of bones, ligaments and tendons leading from muscles. These structures are surrounded by a capsule of connective tissue that provides strength and support. When this capsules becomes thick and tight, it restricts movement at the shoulder joint. The word capsulitis means inflammation of the capsule. Adhesive refers to the adhesions that forms on the capsule. These adhesions are thick bands stiff tissue that affect joint mobility. The synovial fluid that lubricates the joint space and acts as a shock absorber is sometimes lower than normal in the shoulder joint.

shoulder joint

Not Related To Cold Weather

The common term ‘frozen shoulder’ can sometimes be misleading. The fact is that frozen shoulder has nothing to do with the cold. Neither is the shoulder colder than normal, nor is the condition caused by cold weather. Heat therapy can help is relieving some of the symptoms but cold can also be beneficial when the joint is severely inflamed and painful. Stretching exercises are also useful in the management of a frozen shoulder but this is not to ‘warm up’ the joint. These exercises prevent the loss of flexibility that can occur over time if the shoulder is not used to its full range of motion.

Lasts for About Two Years

A frozen shoulder takes about 2 years to resolve. Some cases may ease within 18 months while others can persist for as long as 3 years. Although various treatments may be effective in managing the symptom, the vast majority of cases just require time to resolve. Arthroscopic surgery is reserved only for severe cases that do not respond to treatment or continues to persist past 2 years with intense symptoms. There is no cure for frozen should and it is very much a matter of waiting.

Three Different Stages (Freezing, Frozen, Thawing)

The progression of the condition over the 18 months to 2 year period can be divided into three stages:

  • Freezing stage where the pain arises and gradually gets worse over time with restriction at the shoulder joint. It tends to last anywhere from 6 weeks to 9 months.
  • Frozen stage is where the pain may ease significantly but the stiffness remains and may even worsen. It tends to last for around 4 to 6 months.
  • Thawing stage is where the normal joint flexibility slowly returns. Pain is minimal if present at all. This stage tends to last for around 6 months to 2 years.

Resolves On Its Own Without Treatment

While a frozen shoulder lasts for around 18 months to 2 years, various treatments may be carried out to help with the management of the symptoms. Ultimately frozen shoulder resolves on its own, not due to the treatment that is prescribed. In fact, no treatment is necessary for a person who has mild symptoms that can be tolerated. This means that the condition spontaneously resolves – goes away on its own without the need for treatment. However, this does not mean that treatment is unnecessary. Treatment can help improver quality of life and possibly hasten the resolution. This includes both prescription medication, physical therapy and stretching exercises.

Linked To Certain Disease

There are a number of systemic diseases that tends to increase the risk of a frozen shoulder. It is important to note that these diseases are not a cause of the condition but rather contribute to the possibility of frozen shoulder arising. Most of these underlying conditions have nothing to do with the shoulder joint itself.  Diabetics are at a greater risk of developing frozen shoulder and the risk almost doubles among insulin-dependent diabetics. Other conditions include thyroid problems (both overactive and underactive thyroid gland), cardiovascular diseases, tuberculosis and Parkinson’s disease.

Immobility Increases Risk

Apart from the diseases mentioned above, any person who is immobile or has significantly reduced mobility is at risk of developing a frozen shoulder. Even if only the arm or shoulder is immobilized there is a higher risk of frozen shoulder developing. For this reason a frozen shoulder may be more likely to occur in the elderly, with a fractured arm, after a rotator cuff injury, prolonged recovery from surgery or as a result of immobility due to a stroke. Once again these conditions are not the cause but rather a risk factor.

References:

emedicine.medscape.com/article/1261598-overview

orthoinfo.aaos.org/topic.cfm?topic=a00071


Article reviewed by Dr. Greg. Last updated on February 7, 2014