Frozen Shoulder: It’s Painful, but Treatments Are Available

If you have pain in your shoulder that starts gradually and builds over time, making it hard to move, you could have a condition known as “frozen shoulder.”

The pain may be worse at night, and it may feel like a dull ache. Your shoulder may be difficult to move – even if someone tries to move it for you. Daily activities can become harder and harder to do.

It’s a condition that usually gets better on its own, but that can take months or years. Take heart: The specialists at Lehigh Valley Orthopedic Institute can help.

The technical name is adhesive capsulitis, and it means the shoulder capsule – the connective tissue surrounding your shoulder joint – gets tight and stiff. That causes pain and makes it hard to move.

Frozen shoulder usually has three stages:

• Freezing, in which the pain worsens slowly and range of motion decreases; can last six weeks to nine months.
• Frozen, in which the pain may ease a bit, but the joint remains stiff and regular activities are hard; may last four to six months.
• Thawing, in which the ability to move the shoulder slowly improves; but may last another six months to as long as two years.

While its exact cause is not known, frozen shoulder happens mostly in women who are age 40 to 60. Diabetes, as well as thyroid and cardiac problems, might make the condition more likely. You also might get it after a shoulder has been immobilized for a while, perhaps following an injury or surgery.

“We start with a physical exam, in which we test a patient’s range of motion, comparing how much they are able to move on their own to how much we are able to manipulate the shoulder manually,” says primary care sports medicine doctor Dimitry Belogorodsky, DO, with Lehigh Valley Orthopedic Institute. “We may also order imaging studies such as X-ray, ultrasound or MRI.” 

“Most of the time, surgery is not required,” says Gene Yoo, DO, also a primary care sports medicine doctor at Lehigh Valley Orthopedic Institute. “Many people get better on a combination of hot and cold compresses to reduce swelling, anti-inflammatory medications and physical therapy,” he says.

Physical therapy also can be a big help to manage the pain of frozen shoulder, and to increase the ability to move the shoulder. Physical therapists at LVHN Rehabilitation Services teach a variety of stretching and range-of-motion exercises that those with frozen shoulder can do at home.

Other treatment options are available if needed. Steroid injections may help. Another option is hydrodilation, in which sterile fluid is injected into the joint to gently stretch the shoulder capsule. It’s also possible that a doctor may recommend manipulating your shoulder joint while you are under anesthesia, or arthroscopic surgery to make small incisions in the tight parts of the joint capsule.