Frozen shoulder is a painful condition in which the shoulder becomes stiff with loss of shoulder movements. Over a period of time, it may affect all movements of the shoulder, impairing the quality of life as everyday tasks such as dressing and bathing becomes a challenge. Pain in the frozen shoulder is poorly localized and felt deep inside the joint. It is constantly present although in initial stages it may only manifest at night when lying on the affected side.

Understanding the symptoms and treatment options can help in managing and overcoming this condition effectively.

What is a Frozen Shoulder?

A frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness, pain, and limited range of motion in the shoulder joint. It occurs when the connective tissue surrounding the shoulder joint (the joint capsule) thickens and tightens, restricting movement. This can significantly impact daily activities such as dressing, bathing, and even sleeping.

Key Features of Frozen Shoulder:

• Pain felt deep inside the joint, often worse at night or when lying on the affected side.
• Progressive stiffness and reduced range of motion.
• Formation of adhesions (scar tissue) that tighten the joint capsule, further limiting movement.

The shoulder joint comprises three bones: the humerus (arm bone), scapula (shoulder blade), and clavicle (collarbone). The large rounded head of the humerus fits into the scapula’s socket, allowing a wide range of movement. In the frozen shoulder, the joint capsule becomes thickened and tight, restricting these movements.

Causes of Frozen Shoulder

The exact causes of frozen shoulder remain unclear, but several factors increase the risk of developing this condition:

• Gender and Age: Women aged 40-60 are most commonly affected.
• Medical Conditions:
• Diabetes (5 times higher risk).
• Thyroid disorders (both overactive and underactive).
• Parkinson’s disease.
• Shoulder Immobilization: Prolonged inactivity after a fracture, surgery, or stroke.
• Other Health Issues: Chronic inflammatory conditions or recent trauma to the shoulder.

Who is At Risk for Developing Frozen Shoulder?

Frozen shoulder occurs mostly in adults between the ages of 40 and 60, but it can occur at any stage under certain conditions. Research tells us that women are more prone to this condition due to menopause. Besides this, those who have gone through an injury or surgery can develop the symptoms. In addition, the following health conditions can also be a risk factor:

• Thyroid
• Breast cancer
• Lung diseases
• Cardiovascular diseases
• Heart surgery
• Polymyalgia rheumatica
• Parkinson’s disease

Symptoms of Frozen Shoulder

Understanding the symptoms is crucial for early diagnosis and treatment. Common symptoms include:

• Persistent, deep shoulder pain.
• Stiffness making it difficult to perform daily tasks.
• Gradual worsening of symptoms over weeks or months.
• Pain that is initially worse at night or during certain movements.

Shoulder pain can result from various conditions, but understanding the difference between Rotator Cuff Tear vs Frozen Shoulder is crucial for proper diagnosis and treatment.

Stages of Frozen Shoulder

1. Freezing Stage (6-9 months): Pain and stiffness gradually worsen.
2. Frozen Stage (4-12 months): Stiffness dominates, but pain may reduce.
3. Thawing Stage (6 months-2 years): Gradual improvement in movement and reduction in pain.

Frozen Shoulder Diagnosis

Doctors perform two types of physical tests to diagnose frozen shoulders.

• Active test: In this test, patients need to move their shoulders by themselves.
• Passive test: In this test, doctors assist patients during shoulder movement to note the difference.

Consult with orthopedic surgeons. Sometimes, doctors also recommend an X-ray, MRI, or ultrasound for a frozen shoulder test.

Frozen Shoulder Treatment

Frozen shoulders get healed over time with a careful resting period, but it is not smart to avoid it for long. Sometimes the condition is not improved through conservative methods; then, it is important to discuss it with your doctor and undergo surgical treatment.

1. Physical therapy

Physical therapy or rehabilitation consists of specific exercises and stretches. Initially, your therapist assists you in this, but as your condition improves, you start doing it on your own. Regular gentle massage is also a beneficial way to ease tightness and restore mobility. This is one of the fastest and safest ways to get rid of a frozen shoulder.

2. Medications

• NSAIDs (Nonsteroidal Anti-inflammatory Drugs): Help reduce pain and inflammation.
• Steroid Injections/Corticosteroid injection: To reduce pain and improve the condition, doctors inject a powerful anti-inflammatory medicine- Cortisone. It is injected directly into the shoulder to reduce inflammation and pain. Corticosteroid injections provide temporary relief from severe pain.

3. Hot and Cold Therapy

Therapies are often effective in these types of injuries. Certain exercises are beneficial in improving the condition but you should do it under expert guidance. In severe conditions, a therapy session needs medical intervention too.

• Heat therapy improves blood circulation and relaxes stiff muscles.
• Cold therapy reduces inflammation and numbs pain.

4. Hydrodilatation

This procedure involves injecting sterile fluid into the joint capsule to stretch and loosen the tissues, improving mobility. In this treatment, doctors gently inject sterile fluid into the shoulder joint which improves the condition of the capsule. The process is conducted by a radiologist who ensures the right placement of the fluid.

5. Surgical Options

If conservative treatments fail, the following surgical interventions may be recommended:

• Manipulation Under Anesthesia (MUA): The doctor moves the shoulder to break adhesions. When other treatment options do not work, doctors put you to sleep through anaesthesia and manipulate your shoulder movements. They forcibly move shoulders to loosen up capsule tissue.
• Arthroscopic Surgery: A thin pencil-sized surgical tool, known as an arthroscope which has a camera and light on its tip, is inserted into the shoulders. It transmits the images on the monitor. Depending on these images, further surgical actions are performed. Minimally invasive surgery to remove scar tissue and adhesions.

6. Non-surgical and Home Remedies for Frozen Shoulder Treatment

Although, you should not avoid frozen shoulders and better consult with a professional doctor. But, in some cases, a few home remedies are also effective.

• Gentle shoulder exercises at home.
• Avoiding prolonged immobility.
• Proper posture and ergonomic adjustments.
• Start with warming up to ensure adequate blood flow so that you do not encounter any further injury during the process. Taking a bath with warm water is recommended. You can add Epsom salt to maximize the results.
• Besides this, you should also avoid processed foods, carbonated beverages, frozen food, and alcohol.

Alternative Medicine to Treat Frozen Shoulder

Acupuncture

You can treat frozen shoulders through natural remedies like acupuncture. There are certain points (Zhongping, LI 14, and Ashi Point) around your shoulders that are targeted in the acupuncture sessions to improve blood flow and movability.

Nerve stimulation

There are also electrotherapy modalities to bring instant relief. These are Transcutaneous Electrical Nerve Stimulation (TENS) and Interferential Therapy (IFT). In this process, electrical lights are employed in the affected area to bring relief to the patient.

Preventing Frozen Shoulder

While some risk factors like age and medical conditions are unavoidable, these measures can reduce the likelihood of developing frozen shoulder:

• Engage in regular shoulder exercises to maintain mobility.
• Keep the shoulder moving after an injury or surgery.
• Perform regular stretching exercises.
• Seek early treatment for shoulder injuries to avoid prolonged immobilization.
• Manage underlying conditions like diabetes and thyroid disorders effectively.

When to See a Doctor?

Consult a doctor if you experience severe pain, persistent stiffness, or if the condition worsens despite self-care measures.

Frequently Asked Questions

1. Who is at Risk of Developing a Frozen Shoulder?

Women aged 40-60, individuals with diabetes, thyroid disorders, or those recovering from shoulder injuries are at higher risk.

2. How Long Does the Frozen Shoulder Last?

Frozen shoulder can take up to 3 years to resolve fully, depending on the treatment and individual response.

3. Is Frozen Shoulder Curable?

Yes, with timely intervention and appropriate treatment, most individuals regain full or near-full shoulder mobility.

4. Can Frozen Shoulders Recur?

While rare, recurrence is possible, especially if underlying risk factors are not managed.

5. What Exercises are Helpful for Frozen Shoulders?

Gentle stretching, pendulum exercises, and physiotherapist-supervised strengthening exercises are recommended.

6. How to Cure Frozen Shoulders Quickly?

Frozen shoulder takes time to heal, but physiotherapy, stretching exercises, and anti-inflammatory medications can speed up recovery. In severe cases, steroid injections or hydrodilatation may help.

7. What Should Do and Don’ts for Frozen Shoulder?

• Do’s: Perform gentle stretching, apply heat or cold packs, and follow prescribed physiotherapy.
• Don’ts: Avoid sudden, forceful movements, prolonged immobility, or skipping rehabilitation exercises.

8. How to Get Rid of Frozen Shoulders?

Consistent physiotherapy, mobility exercises, pain management (NSAIDs or heat therapy), and in some cases, steroid injections can help relieve frozen shoulders.

9. How to Sleep with a Frozen Shoulder?

Sleep on your unaffected side with a pillow supporting your affected arm. Use a warm compress before bed and keep your shoulder slightly elevated for comfort.

10. How to Treat Frozen Shoulders at Home?

Apply heat therapy, do gentle stretching, practice mobility exercises, and use over-the-counter pain relievers. Avoid complete rest to prevent stiffness.

11. Can Frozen Shoulders Cause Headaches?

Yes, frozen shoulders can cause headaches due to muscle tension and restricted movement affecting the neck and upper back.

Read more about - Headache Types: What You Need to Know

12. Is Physiotherapy Good for Frozen Shoulder?

Yes, physiotherapy is the best treatment for frozen shoulder. It improves mobility, reduces stiffness, and speeds up recovery with guided exercises.