What Causes Frozen Shoulder and Does it Self-heal?

Frozen shoulder or ‘adhesive capsulitis’ is a very common ailment characterized by a stiff painful shoulder joint. If you have a frozen shoulder, your arm and shoulder movement is significantly limited. You would typically find the shoulder pain getting worse and then finally see improvement. This condition is also referred to as ‘periarthritis” or simply as a “painful stiff shoulder”.

Our shoulder joint is a ball-and-socket joint that operates like a smooth machine under optimum conditions. However, over time, the joint may accumulate scar tissue from the joint around it growing thicker. As a result, you would not be able to move it as smoothly. This condition is frozen shoulder. The adhesions (stiff tissue) and inflammation of the joint lead to shoulder pain.

Advanced age (over 40), or medical conditions such as diabetes, hormonal imbalance, or a weak immune system could lead to a frozen shoulder. Shoulder pain from a frozen shoulder develops commonly when you are unable to move your arm for a prolonged period (usually several months) due to a serious injury or surgery.

Symptoms of frozen shoulder:

Since it takes a relatively long period for a frozen shoulder to develop, peak, and begin healing, the ailment can be divided into three phases – the freezing stage, the frozen stage, and the thawing stage. Each of these phases has its own distinct symptoms and last for a few months each.

1. Freezing Stage: Your shoulder would begin to stiffen progressively. Moving your shoulder will cause a sharp pain. The shoulder pain is typically worse at night and may cause difficulty in sleeping. This phase usually spans around 2 to 9 months.
2. Frozen Stage: Your shoulder would stiffen further until it is virtually immobilized. The shoulder painwould start dying down. This intermediate phase usually lasts around 4 to 12 months.
3. Thawing Stage: The pain improves considerably. The mobility of the arm is restored gradually during this phase. This recovery phase could last anywhere between 5 to 24 months.

What is the risk factor involved in frozen shoulder?

There are multiple factors that could make you more susceptible to developing a frozen shoulder.

• Age and Sex: It is more commonly seen over 40 and in women.
• Immobility: If your arm has been in a sling or otherwise immobile for over two months, whether it is due to an injury, a surgery, or a stroke, you could develop a frozen shoulder.
• Disease: Diabetes, cardiovascular disorders, tuberculosis, hypothyroidism, hyperthyroidism, Parkinson’s disease, etc. make you more at risk of developing this condition .

Diagnosis and Treatment for Frozen shoulder

Frozen shoulder is usually diagnosed by a doctor through a physical examination that exposes the typical symptoms of the ailment seen in the patient. This is typically followed by a series of other tests, such as an MRI and an X-ray, to confirm frozen shoulder and rule out other possible ailments such as arthritis.

While a frozen shoulder can self-heal over a period of several months to a few years if left untreated, a combination of medical treatments is highly recommended for a speedy and successful recovery.

• Physical Therapy: The most common and effective treatment for shoulder pain is physical therapy. You would be prescribed a series of exercises that can be easily continued at home. A frozen shoulder exercise would be targeted at helping you stretch your joint and facilitating  movement on the immobile arm. A shoulder exercise routine would ideally include simple and gentle free-hand exercises that grow in intensity as your mobility and pain-threshold increases.
• Medication: Generic anti-inflammatory medicines like aspirin and ibuprofen are usually used to reduce shoulder pain. If the pain gets unbearable, your doctor may prescribe you a corticosteroid injection on the inflamed shoulder joint. Steroid injections are preferred at an early stage of frozen shoulder.
• Home Care: Home care is indispensable, especially in conjunction with shoulder exercises. Ice packs are also used on the affected  shoulder.
• Surgery: Surgery is usually reserved as the last resort when the patient is not responding adequately to the other treatments. The surgery performed is usually one of two types, the shoulder is physically made to undergo a range of movements under anaesthesia to break up the stiff tissues or an instrument  called the  ‘arthroscope’ is inserted through a cut and used to remove scar tissue.

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Precautions To Prevent Or Manage A Frozen Shoulder

For effective recovery from a frozen shoulder, treatment should be initiated sooner rather than later. Especially if you have shoulder pain due to an injury, opting for early medical help  would help you recover much better and be the safest route.

Managing comorbidities, such as cardiovascular disorders, diabetes, and thyroid disorders, would be a good preventative measure to steer clear of a frozen shoulder.

FAQs of Frozen Shoulder:

1. What is frozen shoulder pain like?

Frozen shoulder pain is usually a recurring & persistent pain that cripples the patient due to the immobilizing feeling.

2. What is the best treatment for frozen shoulders?

The best treatment for a frozen shoulder is a holistic physical therapy schedule. While this is the safest and most affordable way to curb shoulder pain, sometimes surgery is best-suited, for instance, if an injury is involved.

3. How long does a frozen shouldertake to go away?

A frozen shoulder may take anywhere between 2- 21 months to heal adequately. In some severe cases, the recovery may not be complete. In such cases, you may find yourself still struggling with mobility when performing household chores and suffer sporadic bursts of pain.

4. Is it OK to massage a frozen shoulder?

Massaging a frozen shoulder would be very beneficial as this will help improve circulation and calm the inflammation. Applying an ice pack for 15 minutes every day is considered an integral part of home-care for patients as this would help relax muscles and reduce swelling.

5. How do you test for frozen shoulder?

The doctor usually diagnoses a frozen shoulder through physical examination that tests the range of motion permitted by your shoulder and the associated pain experienced. Other tests like MRIs and X-Rays substantiate this diagnosis and rule out other ailments such as an impending heart attack (left shoulder pain is typically considered a symptom), arthritis, tear in the rotator cuff, and tendonitis.