Frozen shoulder (also called adhesive capsulitis) occurs when pain and stiffness limit your shoulder movement. The symptoms can worsen for months until, eventually, you can’t move your shoulder at all. Left untreated, frozen shoulder may get better in two to three years. You may regain more range of motion with treatment, and your symptoms may improve sooner.
At Summit Orthopedics, our shoulder experts in the Minneapolis/St. Paul area offer the full range of treatments for frozen shoulder. Whether you need nonsurgical therapy or a procedure to unlock your shoulder, we’ll find a solution to relieve the pain and get the joint moving again.
Frozen Shoulder Stages
Frozen shoulder moves through three stages, gradually worsening and then slowly improving.
- Freezing stage: Your shoulder pain increases when moving and resting the joint, and you lose range of motion. This stage may last six weeks to nine months.
- Frozen stage: Your pain may get better, but the shoulder is so stiff you can’t move it. This stage may take four to six months.
- Thawing stage: You slowly regain the ability to move your shoulder, but returning to normal range of motion may take up to two years.
What Causes Frozen Shoulder?
A casing of connective tissue called the shoulder capsule surrounds and stabilizes the joint. Frozen shoulder occurs when the joint capsule thickens, causing pain and stiffness. Why this change occurs isn’t clear, although experts think it may be due to inflammation.
The diagnostic process starts by talking with you about your symptoms, reviewing your medical history, and conducting a detailed physical examination. Comparing the range of motion between the affected shoulder and the normal shoulder usually confirms the condition.
Who Is Most Likely to Develop Frozen Shoulder?
People usually develop frozen shoulder between the ages of 40 and 60. It affects women more often than men, possibly due to hormone changes that happen before and after menopause. The female hormone estrogen affects women’s heart health, blood sugar and possibly joint inflammation, all of which can impact a woman’s risk of frozen shoulder. Levels of estrogen fluctuate widely during perimenopause (the years leading up to menopause) and drop off after menopause.
Risk factors for frozen shoulder include:
Diagnosing Frozen Shoulder
Most of the time, doctors can diagnose frozen shoulder based on symptoms, medical history and a physical exam. They may also order imaging tests to look for other conditions that could cause the symptoms.
Medical History and Physical Exam
Your doctor will ask about your symptoms, including when they started, what they feel like, whether they occur with movement or at rest (or both), and whether they’ve worsened over time. The doctor will also want to learn about your medical history, especially any recent shoulder injuries you may have had.
After discussing your symptoms and past medical issues, the doctor will check your shoulder. They will gently move your arm in different ways to see if your shoulder hurts and how well it moves. The doctor will also ask you to move your shoulder yourself. They will compare how your injured shoulder moves to how your healthy shoulder moves.
Imaging
Imaging tests can help your doctor confirm a diagnosis of frozen shoulder by ruling out other causes. Tests they may order include:
- X-ray: X-rays help look at bones and can show bone-related injuries or conditions like arthritis that can also cause a limited range of motion.
- MRI: MRIs show soft tissues more clearly than X-rays, allowing your doctor to look for injuries like a rotator cuff tear. This injury can cause symptoms similar to a frozen shoulder.
- Ultrasound: Like an MRI, an ultrasound can show soft tissue injuries better than an X-ray, allowing your doctor to look for causes of symptoms that mimic a frozen shoulder.
Nonsurgical Treatment
Most patients with frozen shoulder get better with nonsurgical treatment. Improvement may come slowly, so it’s essential to be patient and follow your doctor’s instructions closely. You may need more than one type of nonsurgical treatment. Your doctor may recommend:
- Cortisone shots: These steroid injections can help with frozen shoulder symptoms by reducing inflammation in the joint.
- High-volume injection: Also known as hydrodilatation, this treatment injects sterile fluid into the shoulder, stretching the joint capsule and improving pain and range of motion.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These pain-relieving medicines, which include aspirin and ibuprofen, are available without a prescription.
- Nerve blocks: An injection of anti-inflammatory medicine near a nerve or group of nerves can temporarily relieve pain.
- Orthobiologic (regenerative) injections: These injections, such as platelet-rich plasma therapy, use platelets or other substances from your body to aid healing.
- Physical therapy: A physical therapist can teach you range-of-motion exercises to help you regain mobility in your shoulder.
- Transcutaneous electrical nerve stimulation (TENS): A device sends an electrical current through small pads attached to your shoulder. The current blocks pain messages from your nerves to your brain.
If you have a frozen shoulder, it’s important not to try to force it to move. This could injure the soft tissues. Your treatment progress may be slow, but it’s still positive. Don’t trigger a setback by trying to speed up the process.
Surgical Treatment
You may need surgery to fix your frozen shoulder if your symptoms and range of motion don’t improve after months of nonsurgical treatment. Your doctor may recommend:
- Manipulation under anesthesia: While you’re asleep, the doctor will move your shoulder to stretch the tight joint capsule and any scar tissue from a previous injury. Loosening the tissues can improve your range of motion.
- Shoulder arthroscopy: Your doctor will make small incisions in your shoulder and cut through the tight joint capsule tissue to release the tension.
Can You Prevent Frozen Shoulder?
Frozen shoulder can’t always be prevented, but seeking early treatment for a shoulder injury may reduce your risk. Seek medical help as soon as possible if you have pain or trouble moving your shoulder after an injury. In addition, if you have diabetes or a thyroid problem, managing the condition may help you avoid a frozen shoulder.
Care for Frozen Shoulder at Summit Orthopedics
At Summit Orthopedics, our shoulder experts have extensive experience in treating frozen shoulders. This knowledge helps them find the ideal treatment to help every patient. Your doctor will create a treatment plan that’s unique to you, and they’ll work with physical therapists and other providers to unlock your shoulder’s range of motion. With our team on your side, you can move past shoulder pain and stiffness and start feeling better.
Summit Orthopedics surgeons are available at nearly 30 convenient locations across the Minneapolis/St. Paul metro area, serving Minnesota and western Wisconsin. Our state-of-the-art, comprehensive orthopedic centers offer same-day appointments from a team of experts who offer the full scope of orthopedic care.
Find your Summit Orthopedics shoulder expert, request an appointment or call us at (651) 968-5201 to schedule a consultation.
