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How Does a Shoulder Become “Frozen” – and What Can I Do About It?

Summit hand and upper extremity surgeon J.P. Delaney, M.D., explains the painful condition called “frozen shoulder” and shares what sufferers can do about it.

“Frozen shoulder” — even the name sounds ominous. But what is it? And most importantly, what can a person do to avoid getting frozen shoulder — or to get better as fast as possible?

“We don’t know exactly why the shoulder becomes frozen,” said J.P. Delaney, M.D., one of Summit’s hand and upper extremity surgeons. The painful condition is associated with certain medical problems, including diabetes, endocrine problems (thyroid issues), and neurologic issues. It can also happen after an injury or surgery.

What is frozen shoulder?

In essence, frozen shoulder is an uncontrolled inflammatory response, where the shoulder capsule and the ligaments become significantly inflamed and thickened. This inflammation and thickening results in the shoulder’s range of motion becoming limited — people with frozen shoulder just can’t move their shoulder beyond a certain point.

“Usually, the joint capsule and ligaments are like rubber bands. They stretch back and forth,” Dr. Delaney said. “But in frozen shoulder, they turn into ropes — and like ropes, they stop you from moving beyond a certain range.”

Frozen shoulder typically goes through three phases:

“The kicker is that we don’t know how long each stage is going to last,” Dr. Delaney said. Each of the three stages of frozen shoulder can last from a couple of months up to a year.

What can I do about frozen shoulder?

The goal of treatment is to help move the shoulder through the three phases more quickly. Physical therapy can be helpful, including gentle stretching and exercises to improve the overall position and posture of the shoulder.

“The therapeutic goal is to maintain the motion that you have, but focus on the overall biomechanics as well, so that your shoulder is in the optimal function once the frozen shoulder has run its course,” Dr. Delaney said.

Another option, which can be done in combination with physical therapy, is to have a corticosteroid injection. This simple, office-based procedure can help with pain and reduce inflammation. “We suspect that by decreasing inflammation, we can move the progression from the freezing stage to the frozen and thawing stages faster,” Dr. Delaney said.

Those two options — physical therapy and injections — help most people manage and recover from frozen shoulder without surgery.

If those treatments aren’t effective, some people opt for hydrodilatation, an outpatient procedure that injects numbing medication into the joint capsule and flushes water into the area to stretch it out, restoring motion. Surgery is generally a last resort, but it can help to “break the ice” of frozen shoulder in certain cases.

Summit Orthopedics provides personalized hand and wrist expertise

The function of our hands is integrated through our wrists and arms to our shoulders; a problem anywhere along our arm may have a significant impact on hand function and quality of life. Summit physicians receive the highest levels of training and exclusively provide individualized care for conditions of the hand, wrist, and elbow. Start your journey to better function and less pain. Find your hand expert, request an appointment online, or call us at (651) 968–5201 to schedule a consultation.

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