Within the shoulder, a capsule of connective tissue surrounds the bones, ligaments, and tendons that make up your shoulder joint. Sometimes the capsule thickens and contracts, causing pain, stiffness, and immobility. This condition is called frozen shoulder, or adhesive capsulitis.
While the causes of frozen shoulder aren’t fully understood, it is more common among women between the ages of 40 and 60 and those with diabetes. Other risk factors include hypothyroidism, hyperthyroidism, Parkinson’s disease, and cardiac disease.
Also, frozen shoulder can develop following a shoulder injury or lengthy period of immobilization. One way to help prevent frozen shoulder is through early movement after a shoulder injury.
The orthopedic doctors at the Center for Orthopaedic Surgery and Sports Medicine in San Antonio are experts at diagnosing and treating frozen shoulder. Learn more about the injury below.
Symptoms of Frozen Shoulder
The main symptoms of adhesive capsulitis are a dull or aching pain, stiffness, and restricted motion in the shoulder. The pain is usually located over the outer shoulder area and upper arm and can worsen when attempting to move the shoulder.
Frozen shoulder develops in three stages. The first “freezing” stage, which typically lasts from 6 weeks to 9 months, is characterized by the slow onset of pain that gradually worsens, and the loss of mobility in the shoulder. The second “frozen” stage is marked by a slow improvement in pain, although stiffness remains. This stage may last for 4 to 6 months. During the final “thawing” stage, shoulder motion slowly returns to normal. This could take as few as 6 months or as long as 2 years.
Treatment Options for Frozen Shoulder
Usually, frozen shoulder gets better on its own, but full recovery can take two to three years or longer. In the meantime, treatment can control pain and help facilitate motion.
Pain relief can be achieved with oral anti-inflammatory medications such as ibuprofen or acetaminophen, or with corticosteroid injections. Sometimes, a hot compress can be effective.
To restore motion, your orthopedic doctor will probably recommend physical therapy for stretching and range-of-motion exercises.
More than 90 percent of patients report improvement with these simple treatments. However, if these methods aren’t successful, nerve blocks may be used to limit your pain and enable you to undergo more aggressive physical therapy.
If there is ultimately no improvement in pain or mobility despite physical therapy and anti-inflammatory medication, surgical intervention may be considered. The goal of surgery is to stretch or release the contracted shoulder joint capsule through manipulation under anesthesia or shoulder arthroscopy. The former involves sedating the patient and forcing the shoulder to move, causing the capsule to stretch or tear. With arthroscopy, the surgeon makes several small incisions around the shoulder and, guided by small camera, cuts through the tight portions of the joint capsule.
Following these procedures, physical therapy is essential for maintaining the motion achieved with surgery. Recovery can take anywhere from six weeks to three months.
If you are experiencing shoulder pain and limited movement, call the Center for Orthopaedic Surgery and Sports Medicine to schedule an appointment with one of our physicians. You can reach us at (210) 692-7400 or you can complete our online appointment request form.