How is a frozen shoulder possible and what can be done to treat it?
“Frozen” only seems like a strange term for medical professionals to use to describe a physical condition if you think of it in relation to temperature and to being cold. Definition number 2 in the Merriam Webster dictionary describes a state of being incapable of being “changed” or “moved” or “undone” and also lists “not available for present use”. That is exactly what happens when someone develops a frozen shoulder.
Adhesive capsulitis, or frozen shoulder as it is more commonly known, usually strikes between the ages of 40 and 60, due to the thickening of the connective tissue that holds the bones that make up the shoulder joint together. As the tissue continues to thicken, the joint can become so tight that mobility becomes extremely limited. Researchers are still trying to discover the exact cause of this painful condition which worsens over time. While most people do improve and get their range of motion back, it can take a significant amount of time; 2 to 3 years being typical.
While repetitive motion and overuse associated with participating in sports and working at particular types of occupations are usually blamed for this kind of issue, so far, there does not seem to be any definitive evidence that this is the case with frozen shoulders. In fact, just the opposite has been observed. When something like an injury or surgery results in immobilization of the shoulder, it seems to precipitate the thickening, which hastens the development of a frozen shoulder. In addition, once the condition begins and it becomes painful and difficult to move the joint, many people try to protect it by not moving, which, in turn, actually makes it worse.
Certain medical conditions also appear to have a correlation with the development of a frozen shoulder, although, once again, the exact reason is not clear. Some of those conditions include:
- Diabetes
- Cardiovascular disease
- Parkinson’s disease
- Thyroid disorders – including both hypothyroidism and hyperthyroidism
- Tuberculosis
Stages of Frozen Shoulder Development
An interesting aspect of frozen shoulder is that most cases progress through three fairly distinct stages. These are:
- Freezing Stage – generally lasting somewhere between 6 and 9 months, this stage is characterized by increasing pain, especially while trying to sleep at night, and decreasing mobility.
- Frozen Stage – in the second stage, which may last up to a year, the stiffness becomes more pronounced, making any activity or function that requires the affected shoulder very difficult. The one silver lining to this stage is that the pain may begin to decrease.
- Thawing Stage – the final stage has its share of good news and bad news. The pain continues to decrease and the range of motion starts returning but the progress is frustratingly slow. In fact, the “thawing” stage can take as long as 2 years.
Treatment
There is, currently, no cure for frozen shoulder. Treatment mainly consists of conservative options that focus on mitigating the pain as much as possible and preserving the range of motion. Your healthcare professional will likely recommend some combination of:
- Hot and cold compresses
- Non-prescriptions medications
- Anti-inflammatory medications
- Corticosteroid injections
- Physical therapy
- Joint distention
In cases where non-surgical methods are not effective, surgery may become an option. This would generally be done with some form of shoulder arthroscopic surgery to remove or separate some of the tissue so that movement can be restored.
At Long Island Spine Rehabilitation Medicine, our physicians are committed to more than just treating your symptoms. We strongly believe that each individual is best served through an integrative treatment plan. We focus on finding the underlying cause and providing non-surgical, evidenced-based solutions tailored to your specific condition and needs. If you are experiencing shoulder pain or have questions about any other condition or service, we invite you to schedule a consultation by using our convenient online form by clicking here.