HEALTHY LIVING


shoulder based on your symptoms and a physical exam. “Your doctor will usually order


Get Relief From Frozen Shoulder


Early treatment helps ease pain and restore mobility. :: BY CHRIS ILIADES, M.D. F


rozen shoulder is a painful, limiting condition that can take months to improve.


This condition, called adhesive capsulitis, occurs when the capsule of connective tissue surrounding the shoulder joint becomes inflamed, thickened, and stiff. As the capsule tightens, shoulder


movement becomes limited and painful.


Although frozen shoulder usually


improves on its own, recovery can take two to three years. Treatment can relieve pain, restore movement, and shorten recovery time.


RISK FACTORS There are two types of frozen shoulder: primary and secondary. “Primary frozen shoulder occurs


without any other cause and is more common than secondary frozen shoulder, which occurs due to another condition,” explains Eric Ricchetti, M.D., an orthopedic surgeon at the Cleveland Clinic. A secondary frozen shoulder can


occur during the recovery period after an injury, fracture, or surgery during the recovery period. The exact cause of primary frozen


shoulder is unknown, but it is more common in people with underlying health conditions. “Between 10% and 20% of people with diabetes may develop frozen


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shoulder,” says Ricchetti. “Primary frozen shoulder most


commonly affects adults ages 40 to 60 and affects females more often than males.” Other risk conditions include


thyroid disease, autoimmune disorders, Parkinson’s disease, and stroke.


DIAGNOSIS AND TREATMENT Doctors can usually diagnose frozen


Stages and Symptoms


Frozen shoulder typically develops gradually in three stages: The freezing stage occurs during the


first six to nine months. The frozen stage occurs over the


next two to six months. The thawing, or recovering, stage


lasts from six months to two years, according to Eric Ricchetti, M.D.


FREEZING STAGE Gradually increasing shoulder pain,


often worse at night. Increasing stiffness. Dificulty moving the shoulder.


FROZEN STAGE Pain often begins to improve. Stiffness remains severe. Everyday activities, such as reaching


overhead or getting dressed, become dificult.


THAWING STAGE Pain continues to lessen. Shoulder movement gradually returns. Most people regain complete or nearly complete function.


a shoulder X-ray to rule out other causes, but advanced imaging studies like an MRI are usually not needed,” says Ricchetti. The goals of treatment are to


relieve pain and restore shoulder mobility as the condition gradually improves. Treatment may include heat or cold therapy to reduce pain and swelling.


PAIN RELIEF NSAIDs and steroid injections may be needed in the initial phase when there is more pain present, while stretching and physical therapy exercises may be more of the focus in the second and third stages, when the pain lessens and the goal is to restore normal shoulder motion, explains Ricchetti. If symptoms don’t improve


after about a year of conservative treatment, surgery may be considered. “Surgery is not commonly needed,


but if the noninvasive treatments haven’t relieved the pain and shoulder stiffness after about a year, your provider may recommend other procedures,” he says. “These include manipulation


under general anesthesia to stretch or tear adhesions and relieve tightness, and shoulder arthroscopy to cut through the tight parts of your joint capsule, called capsular release.”


PREVENTION While frozen shoulder can’t always be prevented, early treatment may reduce your risk of severe stiffness. If you develop unexplained


shoulder pain or stiffness, see your healthcare provider promptly. If you’ve had a shoulder injury


or surgery, keep all of your physical therapy appointments and follow your rehabilitation plan. Starting physical therapy early


may help prevent frozen shoulder, or shorten recovery if it develops.


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