Understanding Frozen Shoulder: Causes, Symptoms, and Treatment

Real-Life Scenario: Samuel’s Struggle with Frozen Shoulder

Samuel, a 52-year-old accountant, walked into my clinic with a stiff, painful shoulder. As he slowly eased himself into the chair, he grimaced and held his right arm close to his body. “Dr. Priya, my shoulder’s been bothering me for months now. It started as a mild ache, but now I can’t even lift my arm to put on my jacket,” he said with frustration.

As I listened to Samuel’s story, it became clear he was dealing with a condition known as frozen shoulder, or adhesive capsulitis. This condition is more common than many people realize and can significantly impact daily life if not managed properly.

What is Frozen Shoulder?

Frozen shoulder is a condition that causes stiffness and pain in the shoulder joint. The term “frozen” refers to the restricted movement in the joint, making it difficult or even impossible to move the shoulder freely. The condition typically progresses through three stages:

1. Freezing Stage: This is the initial phase where pain increases, and shoulder movement becomes limited. Samuel was in this stage when he visited my clinic.
2. Frozen Stage: During this phase, pain may subside, but the stiffness remains, severely restricting movement.
3. Thawing Stage: In this final phase, the shoulder gradually regains its range of motion over time.

Research published in the Journal of Shoulder and Elbow Surgery suggests that frozen shoulder affects around 2% to 5% of the general population, with a higher prevalence in individuals between the ages of 40 and 60.

What Causes Frozen Shoulder?

Samuel was curious about why he developed this condition. I explained that the exact cause of frozen shoulder isn’t always clear, but several factors can contribute to its onset:

• Inflammation: Inflammation of the shoulder joint can lead to the formation of fibrous tissue, which restricts movement.
• Injury or Trauma: A fall or an accident that leads to shoulder injury can trigger frozen shoulder.
• Disuse: Immobilization of the shoulder after surgery or injury can also increase the risk of developing this condition.
• Medical Conditions: People with diabetes, thyroid disorders, or cardiovascular disease are at a higher risk of developing frozen shoulder. According to a study published in Diabetes Care, approximately 10% to 20% of people with diabetes experience frozen shoulder.

In Samuel’s case, he mentioned that he had been dealing with type 2 diabetes for several years. This information made it clear that his underlying condition could be a contributing factor.

Who is at Risk of Developing Frozen Shoulder?

Frozen shoulder can affect anyone, but certain groups are more susceptible:

• Middle-Aged Adults: Individuals between the ages of 40 and 60 are at the highest risk.
• People with Diabetes: As mentioned earlier, diabetes increases the likelihood of developing frozen shoulder.
• Individuals with Prolonged Immobilization: Those who have had their shoulder immobilized due to surgery or injury are more likely to experience this condition.

Samuel nodded as I explained these risk factors. “I never realized my diabetes could be linked to my shoulder pain,” he said.

Symptoms of Frozen Shoulder

The symptoms of frozen shoulder typically develop gradually and worsen over time. Samuel described his experience, which matched the classic progression of the condition:

• Pain: Initially, the pain is mild and occurs at night or with certain movements. As the condition progresses, the pain becomes more persistent and severe.
• Stiffness: The shoulder becomes increasingly stiff, making it difficult to perform everyday tasks such as dressing, combing hair, or reaching for objects.
• Limited Range of Motion: Both active and passive shoulder movements become restricted. Samuel demonstrated that he could barely lift his arm past his waist.

Diagnosis of Frozen Shoulder

To confirm the diagnosis, I conducted a physical examination. I gently moved Samuel’s arm to assess his range of motion and asked about his medical history. In some cases, imaging tests such as X-rays or MRIs may be used to rule out other conditions, but the diagnosis is primarily based on clinical evaluation.

The Impact of Frozen Shoulder on Daily Life

Samuel shared how frozen shoulder had affected his daily routine. “I can’t even carry my grocery bags without pain,” he lamented. This condition can significantly impact one’s quality of life, especially when it interferes with simple tasks.

Research in the British Journal of General Practice highlights the psychological impact of frozen shoulder. Patients often experience frustration, anxiety, and even depression due to the prolonged recovery period and limitations on their activities.

Treatment Options for Frozen Shoulder

I reassured Samuel that while frozen shoulder can be a lengthy process, there are effective treatments available.

1. Pain Management

Pain relief is a crucial aspect of treatment. I recommended:

• Over-the-Counter Pain Relievers: Medications like ibuprofen or acetaminophen can help reduce pain and inflammation.
• Corticosteroid Injections: In more severe cases, a corticosteroid injection into the shoulder joint can provide significant pain relief.

A study in the American Journal of Sports Medicine found that corticosteroid injections are effective in reducing pain and improving shoulder mobility during the early stages of frozen shoulder.

2. Physical Therapy

Physical therapy is essential for improving shoulder mobility and preventing further stiffness. I referred Samuel to a physiotherapist who would guide him through exercises designed to stretch and strengthen the shoulder.

Some recommended exercises include:

• Pendulum Exercises: Swinging the arm gently in circles to loosen the shoulder joint.
• Towel Stretch: Holding a towel behind the back and gently pulling it with the other hand to stretch the shoulder.
• Cross-Body Stretch: Gently pulling the affected arm across the body to stretch the shoulder muscles.

3. Surgical Intervention

In rare cases where conservative treatments fail, surgery may be necessary. The two main surgical options are:

• Manipulation Under Anesthesia (MUA): The shoulder is gently moved while the patient is under anesthesia to break up adhesions.
• Arthroscopic Surgery: A minimally invasive procedure to remove scar tissue and adhesions from the shoulder joint.

4. Self-Care and Home Remedies

I advised Samuel to take an active role in his recovery by:

• Applying Heat or Ice Packs: This can help reduce pain and inflammation.
• Practicing Gentle Stretches: Regular stretching can improve flexibility and prevent further stiffness.
• Maintaining a Healthy Lifestyle: Managing his diabetes and maintaining a healthy weight could also improve his overall recovery.

Recovery Timeline

Samuel was eager to know how long it would take for his shoulder to heal. I explained that recovery from frozen shoulder can take anywhere from 1 to 3 years, depending on the severity of the condition and the effectiveness of the treatment plan.

“It’s a slow process,” I admitted, “but with the right approach, you will regain your shoulder movement. Patience and consistency are key.”

Preventing Frozen Shoulder

Before Samuel left, I shared some tips to prevent frozen shoulder from recurring:

• Stay Active: Regular exercise can help maintain shoulder flexibility and strength.
• Manage Underlying Conditions: Keeping chronic conditions like diabetes under control can reduce the risk of developing frozen shoulder.
• Avoid Prolonged Immobilization: If you need to immobilize your shoulder after surgery or injury, make sure to follow a physiotherapy plan to keep the joint mobile.

FAQs About Frozen Shoulder