Frozen Shoulder: symptoms you should know

Pain and stiffness can worsen over time until your shoulder feels frozen in one position. Here is how to get things moving again.

What is frozen shoulder?

It is pain and stiffness in your shoulder that happens slowly. It can worsen until your shoulder seems "frozen" in one position. Although it may take as much as a few years to get completely better, it can improve long before then, especially if you do physical therapy to help with recovery.

Causes

Doctors do not know exactly what causes it, though some things make you more likely to have it. For example, it can happen if you can not move your shoulder very well because of an injury or surgery, or if you have diabetes, which can worsen symptoms and make them last longer. Thyroid problems, Parkinson's disease, heart disease, and certain HIV medications also seem to raise your odds of getting frozen shoulder.

Who gets it?

It is most common if you are in your 50s or 60s, and it is rare for anyone under 40. Women get it more than men. And if you get frozen shoulder on one side of your body, you are up to 30% more likely to get it on the other side.

Physical exam

Your doctor will ask you about your symptoms, injuries and medical history. Then s/he will check your shoulder. S/he will move it herself to see where the pain and stiffness start. This is your passive range of motion. Then s/he will ask you to move it yourself. That is your active range of motion. At the limit, it may feel like your arm is stuck. If you have frozen shoulder, your passive and active range of motion will be less than normal.

Tests

An "injection test" may help narrow down the cause of your symptoms. Your doctor gives you a shot in your arm that dulls the pain. With most shoulder problems, this gives you a bigger range of motion, but it will not change it much if you have frozen shoulder. Doctors typically only use imaging tests like X-rays, ultrasounds and MRIs to rule out other conditions.

Exercises

Once your frozen shoulder pain starts to ease up, your doctor might suggest arm exercises. A physical therapist can give you moves to do as homework. Take it easy at first. If you "push through the pain," you could make things worse.

Medicine

NSAIDs (non-steroidal anti-inflammatory drugs) like aspirin, ibuprofen and naproxen may curb pain and swelling. More powerful drugs called steroids are sometimes injected directly into the joint. But it can be tricky to get them into just the right spot, and even these will only provide temporary relief of your symptoms.

Surgery

Your doctor may suggest this, usually in the "frozen" stage, if nothing else works. There are two methods, sometimes used together. The first is manipulation while you are "asleep" from general anaesthesia. The surgeon moves the joint until it stretches or even tears the tissue. The second method, called arthroscopy, cuts the affected tissue directly. Your surgeon works through small cuts in your skin, using special tools.

Recovery

Frozen shoulder gets better for a lot of people within a year if they do physical therapy and use pain medicines and steroid shots if needed. Even without those methods, most people get better within a couple of years, though if you have diabetes, it may be harder to recover. Surgery works pretty well as long as you stick with your physical therapy afterward to rebuild and keep up your strength and mobility.