Frozen shoulder, or adhesive capsulitis, is a painful orthopedic condition characterized by decreased function and range of motion loss in the shoulder joint.
Symptoms develop gradually, typically over the course of several months. Initially, moving the shoulder results in severe pain and the feeling of stiffness.
After a few months, the extreme level of pain begins to diminish, but more severe stiffness sets in. Using the shoulder typically becomes more and more difficult. Often, patients report difficulty with daily tasks such as brushing their hair or reaching behind their back. Symptoms are generally present for one to three years, and people over the age of 40 — particularly women — are more likely to be affected.
Causes of Frozen Shoulder
In the shoulder joint, a band of connective tissue or capsule surrounds the bones, tendons, and ligaments. When this tissue thickens, movement of the joint becomes restricted.
Current research does not yet understand what causes the tissue to thicken. However, the research has tied this condition to prolonged immobility of the shoulder, as can happen when recovering from a stroke, surgery, arm fracture or shoulder injury.
Certain diseases — including diabetes, cardiovascular disease, Parkinson’s disease and thyroid issues — are also thought to increase the risk of developing this painful and debilitating condition.
Frozen Shoulder Diagnosis
To diagnose frozen shoulder, the doctor will take a medical history and perform a physical examination to determine the extent and severity of your pain.
During the exam, you will be asked to move your arm in various ways, so that the doctor can evaluate the limitations in shoulder movement. The doctor also will ask you to relax your arm muscles, so that the arm can be manipulated to test for the passive range of motion.
In most cases, this type of exam is sufficient to diagnose the condition. However, the doctor may order imaging tests such as X-rays or an MRI to rule out other potential causes.
Treatments for Frozen Shoulder
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are usually recommended to reduce pain and inflammation. Many patients may improve with physical therapy, such as performing range-of-motion exercises to help recover mobility in the shoulder. The benefits of physical therapy are often limited by pain.
For patients with persistent pain, a specialist such as Dr. Engelen can perform an ultrasound-guided regional nerve block (suprascapular nerve) to anesthetize the pain receptors supplying the capsule. This is followed up by a capsule distension and corticosteroid injection. This unique procedure allows the patient to perform therapeutic exercises in a pain-free manner and typically restores activity without the need for further interventions.
In some cases, your doctor may advise a shoulder manipulation procedure. During this procedure, you are administered a general anesthetic. While under anesthesia, the doctor will manipulate the joint in different directions to help ease the tightness in the tissue.
Surgery is rarely a good solution for frozen shoulder. In some limited cases an arthroscopic procedure to remove scar tissue and adhesions in the joint may help, if noninvasive treatments have failed to relieve symptoms.
If you are suffering from shoulder pain or a limited range of motion, contact our office today to schedule a consultation. Our experienced orthopedic doctors can determine if you have frozen shoulder or other related conditions such as a rotator cuff tear or shoulder impingement.