What You Need to Know About Frozen Shoulder

What is frozen shoulder?

Frozen shoulder, or adhesive capsulitis, is a common condition of the shoulder where there is a progressive a loss of range of motion and pain. This condition often happens without a specific cause, where the ligaments that surround the shoulder joint, called the capsule, become stiff and inflamed.

The tricky thing about frozen shoulder is that the reduced range of motion can last 1-3 years, and very little can be done to change this course. The stages of frozen shoulder are described below:

1. Freezing stage: The initial stage of frozen shoulder is characterized by pain that is difficult to pinpoint in the shoulder, and progressive stiffness in certain movements, usually rotating away from the body at the shoulder (external rotation), raising your arm to the side (abduction), reaching behind your back (internal rotation), and reaching overhead (flexion). This stage can last anywhere from 2-9 months, with the shoulder getting progressively stiffer.

2. Frozen stage: The next stage of frozen shoulder is characterized by less or no pain, but severely limited shoulder movement in all directions. This stage can last anywhere from 4-12 months, the end of which the shoulder’s movement starts to improve.

3. Thawing stage: The final stage of frozen shoulder is a progressive improvement in shoulder movement that can last 12 months to 3-4 years. Typically, the most improvement happens closer to the start of this stage, and with the proper treatment movement can be further improved.

Who is affected by frozen shoulder?

Frozen shoulder occurs to women more often than men at a 4:1 ratio, especially in the 40-60 age range. Risk factors for frozen shoulder include type 2 diabetes, hypothyroidism, history of stroke or shoulder injury, Parkinson’s disease, and cancer.

Are we sure this is frozen shoulder?

If you’re experiencing these symptoms, it’s important to have your shoulder checked by a professional! A physiotherapist can help differentiate frozen shoulder from other shoulder problems like:

  • Rotator cuff tendinopathy
  • Referred pain from neck
  • Shoulder problems post-stroke, like subluxation
  • Osteoarthritis of the shoulder joint
  • Shoulder bursitis
  • Fracture

Note that many of these other conditions can improve significantly with proper care and physiotherapy, so it’s important to make the right diagnosis!

As well, a physiotherapist will help to rule out more serious conditions that could mimic frozen shoulder, like rheumatoid arthritis, lupus, or cancer.

What treatment is available?

Treatment for frozen shoulder depends on the stage and severity of the condition:

Freezing stage: Since this stage is characterized by pain and progressive loss of movement, treatment consists of pain and swelling management, and exercises to preserve range of motion. If pain becomes severe or interferes with sleep, you may be referred to a specialist for medication or corticosteroid injection.

Frozen/thawing stages: Once pain decreases, treatment can begin to improve range of motion of the shoulder. Your therapist may use a variety of techniques like joint mobilization, passive and active movement of the shoulder, joint capsule stretching, or shockwave therapy. As range of motion improves, treatment may shift to improving shoulder strength and function.

If you’re concerned about your shoulder becoming painful and stiff, give us a call and we can help guide you to the right course of action!

About The Author

Jonathan Rankin obtained his MSc in Physiotherapy at McMaster University, and also completed both a BSc and an MSc in Human Kinetics from the University of Ottawa. He has a strong background in exercise, from working as a personal trainer at the University of Ottawa to conducting research on exercise during pregnancy in his master’s degree.

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