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Frozen Shoulder

Frozen Shoulder: Symptoms, Treatment, and Recovery

Frozen shoulder (adhesive capsulitis) is a painful inflammatory condition in the shoulder joint that causes stiffness and loss of range of motion. 

The shoulder joint consists of three bones and strong connective tissue that surrounds it. The connective tissue is called the shoulder capsule. In frozen shoulder, bands of tissue in the shoulder capsule become stiff, tight, and painful, restricting motion. 

While a frozen shoulder can resolve on its own with rest and conservative treatment after months or years, in some cases, you may need medical intervention or surgery. 

Causes of Frozen Shoulder

The cause of a frozen shoulder is unclear. It can happen after an injury to the bones or soft tissue in the shoulder or following an overuse injury like tendonitis or bursitis. It can also happen after shoulder surgery.

Frozen shoulder usually presents after a period of immobilization. If the shoulder is immobile for an extended period, the joint capsule thickens, contracts, and stiffens. 

Frozen Shoulder Risk Factors

Certain risk factors might lead to a frozen shoulder.

  • Age and sex – women over 40 are more at risk
  • Immobility following surgery, an injury, or a condition like a stroke
  • Rotator cuff disorders
  • Diabetes (with a prevalence of up to 20 percent)
  • Other diseases like thyroid disorders, cardiac disease, cancer, and Parkinson’s Disease

Symptoms of Frozen Shoulder

The symptoms of frozen shoulder tend to occur in three phases: the freezing period, the frozen period, and the thawing period. The early freezing period is predominated by pain, the frozen period is dominated by the loss of motion, and the thawing period sees a gradual improvement in symptoms.

  • Pain
  • Stiffness
  • Loss of motion
  • Loss of function
  • Loss of strength

How is Frozen Shoulder Diagnosed?

A physical examination is usually sufficient to diagnose frozen shoulders. During the exam, the orthopedic provider will assess the active and passive range of motion in your shoulder. 

Diagnostic imaging is usually unnecessary, but X-Rays and MRIs can help rule out other conditions. 

Treatment for Frozen Shoulder

Conservative management is the primary treatment for frozen shoulder, and 90 percent of cases will resolve without surgery within 12-18 months. If conservative management fails or the frozen shoulder is severe, your provider may recommend surgery. 

Conservative Treatment

Conservative treatments include physical therapy, stretching, ice, ultrasound, and NSAIDs. The goal of conservative treatment is to reduce inflammation in the shoulder capsule and restore motion. 

Your provider may also recommend steroid treatment to reduce inflammation, whether a cortisone injection into the shoulder joint or oral prednisone. 

Surgical Treatment

If extended conservative treatment fails (usually at least six months) or the frozen shoulder is causing severe pain, your provider may recommend surgery

During surgery for a frozen shoulder, your orthopedic provider will likely use a minimally invasive surgical technique to restore motion in the shoulder. Possible surgical procedures include manipulation under anesthesia or arthroscopic capsular release (adhesiolysis). 

During manipulation under anesthesia, the surgeon forces the shoulder to move to loosen the tightened muscles and cause the scar tissue to tear. During a capsular release, the surgeon will make a series of small incisions to release the scar tissue. 

Recovery Time

Recovery is slow for a frozen shoulder. With conservative management, it may take 1 to 3 years for symptoms to resolve. After surgery, your orthopedic provider will recommend several weeks of physical therapy, stretching, and strengthening exercises – including home exercise programs and supervised therapy. Post-surgical rehabilitation can take from 6 weeks up to 9 months.                                                                            

How Can I Prevent Frozen Shoulder?

As the cause of frozen shoulders is unclear, it is not always possible to prevent it. Orthopedic experts recommend moving and stretching your shoulders frequently to maintain range of motion and strength. If recovering from a shoulder injury or other condition, it’s important not to keep the shoulder immobile for too long because this can lead to frozen shoulder. 

Expert Shoulder Care at Raleigh Orthopaedic

Raleigh Orthopaedic offers comprehensive care for a variety of shoulder conditions, including frozen shoulder. Our experienced shoulder experts will diagnose your condition and work with you to form a treatment plan. Contact us today to schedule an appointment at one of our six convenient locations in Wake County, NC.

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