Frozen Shoulder

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The key takeaways are that frozen shoulder causes pain and stiffness in the shoulder over time limiting movement. It develops in three stages - freezing, frozen, and thawing. Risk factors include age 40-60, immobilization, and diseases like diabetes.

Frozen shoulder affects the shoulder capsule, which becomes tight and stiff, reducing synovial fluid in the joint. It is a ball-and-socket joint made up of the humerus, scapula, and clavicle bones.

Frozen shoulder develops in three stages - freezing with slow onset pain, frozen with worsening pain and stiffness, and thawing with gradual improvement in shoulder motion over 5 months to 2 years.

OrthoInfo Basics

Frozen Shoulder
What does frozen shoulder feel like?
The shoulder Pain from frozen shoulder is dull and aching. It gets worse when
is a complex you move your arm.
structure that The hallmark sign of the condition is being unable to move your
does a lot shoulder. It develops in 3 stages.
for us. Freezing. There is a slow onset of pain during this stage. As
the pain worsens, your shoulder loses range of motion and you
The design of your
may have trouble sleeping. Freezing typically lasts from 6 weeks to
shoulder helps you 9 months.
scratch your back, reach
Frozen. Painful symptoms may actually improve during this
an item on the top shelf, stage, but stiffness continues to worsen. During the 4 to 6
or throw the perfect months of this stage, daily activities may be very difficult.
pitch. Because we use our Thawing. Shoulder motion gradually improves during this stage.
arms so much, anything Completely regaining strength and motion typically takes from 5
that limits our ability to months to 2 years.

move them has a huge


effect on our everyday What parts of the shoulder are affected?
lives. Your shoulder helps you lift your arm, rotate it, and reach up over
your head.
Frozen shoulder, which is
also called adhesive Clavicle
Shoulder (Collarbone)
capsulitis, causes pain Capsule
and stiffness in your
Humerus
shoulder. Over time, the (Upper
shoulder becomes very Arm)
hard to move.
Scapula
(Shoulder
Blade)

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OrthoInfo Basics — Frozen Shoulder

(Shoulder Anatomy — continued from page 1)

It is a ball-and-socket joint made up of three To help your shoulder move more easily,
bones: your upper arm bone (humerus), your synovial fluid lubricates the shoulder capsule
shoulder blade (scapula), and your collarbone and joint.
(clavicle).
In frozen shoulder, the shoulder capsule becomes
The head of your upper arm bone fits into a tight and stiff. In many cases, there is less
rounded groove in your shoulder blade. Strong synovial fluid in the joint.
connective tissue, called the shoulder capsule,
surrounds the joint.

How does frozen shoulder happen?

The causes of frozen shoulder are not fully A few factors may put you more at risk for
understood. developing frozen shoulder.

Over time, the shoulder capsule thickens and Age. People 40 to 60 years old are more likely to
stiff bands of tissue—called adhesions—develop. develop frozen shoulder.
It becomes painful and more difficult to move
Immobilization. If your shoulder has been
your shoulder.
immobilized for a period of time—whether from
surgery or injury—you may be at risk.

Diabetes. People with diabetes are more likely


Adhesions and to develop frozen shoulder. The reason for this is
scarring of joint not known.
capsule
Other disease. Some diseases associated with
frozen shoulder include hypothyroidism, hy-
perthyroidism, Parkinson’s disease, and cardiac
disease.

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OrthoInfo Basics — Frozen Shoulder

How is frozen shoulder treated?

Over time, frozen shoulder will get better on Surgery. Frozen shoulder rarely requires
its own. surgery. However, if your symptoms do not
respond to all other treatments, your doctor
Simple treatments often help control pain and may recommend it.
restore motion.
The goal of surgery for frozen shoulder is to
Nonsteroidal anti-inflammatory
stretch and release the stiffened joint capsule.
medicines. Drugs like aspirin and ibuprofen
reduce pain and swelling. Manipulation under anesthesia. During this
procedure, you are put to sleep. Then the doctor
Steroid injections. Cortisone is a powerful
forces your shoulder to move, which causes the
anti-inflammatory medicine that is injected capsule to stretch.
directly into your shoulder joint.
Arthroscopy. Your doctor will cut through tight
Physical therapy. Specific exercises will
portions of the joint capsule. This is done using
help restore movement and strengthen your
pencil-sized instruments inserted through small
shoulder. Physical therapy is most often the key
incisions around your shoulder joint.
ingredient in treating frozen shoulder.

What will rehabilitation be like?

Whether your treatment involves surgery or difficult, your doctor may use nerve blocks
not, rehabilitation plays a vital role in getting to limit pain and allow for more aggressive
you back to your daily activities. therapy.

Your doctor may suggest you work with a A complete recovery make from 12 to 28
physical therapist to regain strength. months. Although it is a slow process, your
commitment to therapy is the most important
Your therapist may also teach you to use ice
factor in returning to all the activities you enjoy.
and heat treatments to help manage your pain.
If stiffness in your shoulder makes exercise

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OrthoInfo Basics — Frozen Shoulder

For more information

For more information about shoulder pain, its causes, and treatment, visit OrthoInfo at
www.orthoinfo.org.

OrthoInfo is the patient education website of the American Academy of Orthopaedic Surgeons
(AAOS), and is a trusted source of information about musculoskeletal conditions. Our articles are
developed by orthopaedic surgeons, and provide detailed information about a wide range of injuries
and diseases, as well as treatment options and prevention topics.

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This
information is provided as an educational service and is not intended to serve as medical advice.
Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic
surgeon.

© 2019 American Academy of Orthopaedic Surgeons

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