The abrupt shoulder stiffness, potentially limiting the range of motion, can evoke a sense of panic. Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by pain and stiffness in the joint of a shoulder. It typically develops gradually and worsens over time. If you're experiencing shoulder pain and limited range of motion, it's important to understand the signs, diagnosis, and treatment options.

Prevalence and Risk Factors

Frozen shoulder is estimated to affect around 2% to 5% of the population but afflicts more women than men. Moreover, those who may have an increased risk of developing a frozen shoulder include:

• People in the age group of 40 to 60 years
• Pre-existing health conditions such as diabetes, thyroid disorders, and cardiovascular disease
• Previous shoulder injuries or surgeries

Stages of Frozen Shoulder

The stages of a frozen shoulder include:

1. Freezing Stage

During this stage, individuals may experience increasing pain and stiffness in the shoulder. The range of motion becomes limited, making it difficult to perform daily activities like reaching or lifting. This stage can last anywhere from a few weeks to several months.

2. Frozen Stage

In this stage, the pain may decrease, but the shoulder remains stiff. Range of motion is significantly restricted, causing difficulty in even basic movements. This stage can last for several months to a year.

3. Thawing Stage

The thawing stage is characterized by a gradual improvement in shoulder mobility. Pain and stiffness start to diminish, allowing for an increased range of motion. The duration of this stage can vary, lasting anywhere from several months to years.

Please note, the exact duration of each stage can vary among individuals.

Common Signs and Symptoms of Frozen Shoulder

Symptoms generally experienced in a frozen shoulder include:

• Shoulder pain and stiffness: There may be shoulder pain that worsens with movement, can be severe and radiates down the arm as well. There can be stiffness which makes it difficult to perform daily activities.
• Limited range of motion: The pain aggravates on performing lifting activities or reaching overhead.
• Difficulty performing daily activities: Pain and stiffness combined may render the performance of regular day-to-day activities difficult.

Diagnosing Frozen Shoulder

1. Physical Examination and Medical History

Your healthcare provider will start by discussing your medical history and any previous shoulder injuries or conditions you may have had. They will then perform a physical examination to assess the range of motion and strength in your shoulder joint.

During the examination, your healthcare provider may apply pressure to certain areas of your shoulder to identify any tender points.

2. Imaging Tests

To confirm the diagnosis of a frozen shoulder and rule out other potential causes, imaging tests may be ordered.

• X-rays can help your healthcare provider visualize the bones in your shoulder and detect any abnormalities.
• Magnetic resonance imaging (MRI) scans provide detailed images of soft tissues, allowing for a more thorough assessment of the shoulder joint.

By carefully considering your medical history, physical examination findings, and imaging test results, your healthcare provider can make an accurate diagnosis. If you're experiencing these symptoms, it's best to consult a healthcare professional for an accurate diagnosis.

Treatment Options for Frozen Shoulder

The goal of treatment for a frozen shoulder is to relieve pain and improve the range of motion. The most common treatment options include:

1. Non-Surgical Approaches

• Physical Therapy and Exercise: A structured exercise program designed to stretch and strengthen the shoulder joint can help improve mobility and reduce pain.
• Pain Relief Medications: Over-the-counter pain relievers or prescription medications may be recommended to manage pain and reduce inflammation. Corticosteroid injections into the shoulder joint can provide temporary relief from pain and inflammation.
• Heat and Cold Therapy: Applying heat to the affected area can relax the muscles and increase blood flow, giving relief. Cold therapy, on the other hand, can numb the area and alleviate inflammation. Alternate between heat and cold therapy for maximum benefit.

2. Surgical Interventions

While conservative treatments such as physical therapy and medications are often the first line of defence, surgical interventions may be necessary in severe cases. In severe cases where other treatments have not been effective, surgery may be considered to release the tight shoulder capsule.

• Arthroscopic Release Surgery: This involves making small incisions in the shoulder and using a tiny camera called an arthroscope to view and treat the affected area. This procedure allows the surgeon to cut through the tight tissues and release the constraint on the shoulder joint. Arthroscopic release surgery has been shown to significantly improve the range of motion and reduce pain in patients.
• Manipulation Under Anesthesia: In this procedure, the patient is put under general anaesthesia, and the surgeon manually manipulates the shoulder to break up scar tissue and increase the range of motion. This procedure is often followed by physical therapy to regain strength and mobility.

While these surgical interventions can provide relief for patients with frozen shoulders, it's important to note that they are typically reserved for cases that have not responded to conservative treatments.

Self-Care Measures for Frozen Shoulder Relief

While there is no definitive cure for a frozen shoulder, there are several self-care measures that can help provide relief and improve the range of motion in the affected shoulder.

1. Range of Motion Exercises at Home

• Regularly performing a range of motion exercises is crucial for maintaining the flexibility of the shoulder joint.
• Gently move your shoulder in various directions, such as forward and backwards, side to side, and in circular motions.
• Start with gentle movements and gradually increase the intensity as your range of motion improves.
• It is important to avoid overexertion or forcing any movement that causes excessive pain.

2. Proper Posture and Ergonomics in Daily Activities

• Maintaining good posture and ergonomics while performing daily activities can help prevent further strain on the shoulder joint.
• Whether you are sitting at a desk, standing, or lifting objects, make sure to keep your shoulders relaxed and avoid hunching or slouching.
• Additionally, using ergonomic tools such as supportive chairs or adjustable desks can alleviate unnecessary stress on your shoulders.

3. Stress Management Techniques

• Stress can exacerbate the symptoms of a frozen shoulder, so it is important to find effective stress management techniques that work for you.
• Engaging in activities that you enjoy, such as hobbies or exercise, can help reduce stress levels.
• Deep breathing exercises, meditation, and yoga are also excellent techniques for managing stress and promoting overall well-being.

Prevention Strategies for Frozen Shoulder

Some common preventive measures to reduce the risk of developing a frozen shoulder include:

1. Maintaining Shoulder Flexibility

Exercises play a crucial role in maintaining shoulder flexibility and preventing the onset of a frozen shoulder. Include a range of motion exercises, stretching exercises, and strength training exercises in your workout routine to improve blood circulation in the shoulder joint and keep the joint flexible.

2. Warm-up and Cool-down Exercises

Warm-up and cool-down exercises before and after physical activity are important to prevent injury to the shoulder joint. Gentle stretching and mobility exercises can help prepare the muscles and joints for exercise, reducing the risk of overexertion or strain.

3. Avoiding Over-Use

It is important to listen to your body and avoid repetitive or excessive movements that may put unnecessary stress on the shoulder joint. If you engage in activities that require repetitive arm movements, take regular breaks and ensure proper form and technique.

Conclusion

Frozen shoulder can be a challenging condition to manage, but early diagnosis and appropriate treatment can help alleviate symptoms and improve overall shoulder function. If you're experiencing shoulder pain and stiffness, it's important to seek medical attention for an accurate diagnosis and personalized treatment plan.

Consult Apollo's Expert Orthopaedician

FAQs

Q. Are there any medical conditions that increase the risk of developing a frozen shoulder?

Thyroid disorders and autoimmune diseases may be associated with an increased risk of developing a frozen shoulder.

Q. How long does it take to recover from a frozen shoulder?

The recovery period for a frozen shoulder varies from person to person. It can take several months to years for complete recovery.

Q. Can lifestyle factors contribute to the development of a frozen shoulder?

While no specific lifestyle factors have been directly linked to frozen shoulder, maintaining a healthy weight and regular exercise may help avert it.

Q. Can a frozen shoulder affect muscles?

Over time, if left untreated, a frozen shoulder can lead to muscle imbalances around the affected joint.

Medically reviewed by Dr Sonia Bhatt.