What Causes Frozen Shoulder?

Adhesive capsulitis is the scientific name for frozen shoulder, which is a painful condition affecting the shoulder joint. The shoulder is a joint that is made up of three bones: the humerus, scapula, and clavicle (upper arm, shoulder blade, and collarbone). Holding this ball and socket joint together is tissue that is referred to as the shoulder capsule. Frozen shoulder affects this area. The stiffness and pain associated with frozen shoulder will often come on gradually, making it difficult to diagnose or predict. The condition can sometimes get worse before it gets better, lasting up to three years.

A further definition of frozen shoulder is that the capsule becomes very stiff as more and more scar tissue forms around it. Movement is greatly restricted by the tissue and the synovial fluid naturally present in the body’s joints becomes scarcer. Synovial fluid is meant to lubricate the joints so that bones can move freely without friction. The lack of synovial fluid adds to the pain and stiffness.

Frozen Shoulder Symptoms

The symptoms of frozen shoulder are primarily pain and stiffness that gets worse and worse until the shoulder is basically locked up or frozen, as the name of the condition implies. The discomfort surrounds the shoulder, but sufferers can also expect a dull ache in the upper arm and even the lower part of the arm.

The Three Phases Associated with Frozen Shoulder

Freezing Process

• Shoulder pain upon movement
• Pain is more intense in the evening hours
• 6-9 month duration of the condition
• Limited movement

Frozen

• This stage can last 4 months to a year.
• Moving the shoulder becomes more difficult, though the pain might let up some.
• Stiffness worsens

Thawing Out

• The shoulder is beginning to feel right again.
• 6-12 month process of thawing out and getting back to normal

Frozen shoulder affects women more often than men, but why some people are affected and not others is a mystery. People recovering from surgery or stroke with limited mobility are at risk. Also, people between 40 to 60 years of age are more prone to frozen shoulder, as are diabetics and those with Parkinson’s, heart, or thyroid disease.

Diagnosis

Other conditions that cause stiffness and lack of mobility have to be ruled out for an accurate diagnosis of frozen shoulder. See your health professional for an examination. The doctor will ask that you move/rotate your shoulder as they observe. He or she will also attempt to move your arm/shoulder.

The physical exam will probably not involve imaging, but if the doctor is unable to definitively diagnose what’s going on in the shoulder, he or she may order diagnostic imaging. The patient may undergo an MRI, CT scan, or ultrasound imaging to rule out other painful conditions that cause stiffness in the shoulder, like a rotator cuff that’s been torn or perhaps arthritis.

Treatment

Anti-inflammatory medications prescribed by your doctor or over-the-counter medications will ease inflammation in the shoulder. If over the counter meds are insufficient to your pain, speak with your doctor about prescribing a stronger medication.

Strengthening and stretching the muscles in your arm under the direction of a physical therapist can increase the range of motion in the shoulder and help strengthen the muscles and connective tissue.

A corticosteroid injected into the shoulder will help to eliminate pain and reduce inflammation, improving the range of motion.

Sterile water injected into the shoulder capsule acts as a stretching agent. Similar to synovial fluid, sterile fluid lubricates the area so that the shoulder can move more freely.

Surgery is a final option, though it’s not always necessary. Arthroscopic surgery is performed when the other treatment options fail. Two tiny cuts are made in the shoulder, one for inserting a small camera for the surgeon to view the inside of the shoulder, and the second through which instruments can be used to operate.

Frozen shoulder/adhesive capsulitis can last for many months, but you don’t need to suffer through it. Seek medical attention early, and an orthopedic specialist will help you get your shoulder back in working order in no time. Call Advanced Bone & Joint today to schedule an appointment with our orthopedic specialists. Call (636) 229-4222 today, or schedule an appointment online.