Frozen shoulder, also known as shoulder contracture or adhesive capsulitis, is a condition where the synovial membrane – a soft tissue that forms a protective capsule around the shoulder joint – swells, thickens and contracts. Scar tissue forms, leaving less room for the upper arm to move around. This causes pain and restricts movement in the shoulder. The cause of this condition is unknown, but it often occurs in people who have other inflammatory disorders. Other people develop frozen shoulder after an injury or period of immobilization, such as after surgery.
Women are more likely than men to develop adhesive capsulitis, and most patients are roughly between ages 40 and 65. People who have thyroid disease, diabetes, an autoimmune disease, and/or injury, stroke, heart attack, or prolonged immobilization are also at higher risk. Occasionally, however, younger men and women without any of these risk factors will develop frozen shoulder.
Usually only one shoulder is affected, but about one-third of patients experience symptoms in both. Early symptoms include:
If you experience these symptoms, see a doctor immediately. Untreated, the condition will worsen and can last two years or longer. Symptoms usually appear in four stages over about 24 months:
Stage 1, months 1-3: Shoulder pain causes you to limit your arm movement.
Stage 2, months 3-9: The “freezing” stage, where pain continues (although it may lessen) but you experience decreased ability to move your shoulder properly.
Stage 3, months 9-14: The “frozen” stage, where the shoulder is stiff but no longer hurts when you are not moving it.
Stage 4, months 15-24: The “thawing” stage, where your ability to move your shoulder gradually returns.
Non-surgical treatment is the best first option. Usually, this is a mix of physical therapy (PT) and medication. PT will involve significant stretching to prevent loss of motion. Your doctor may also prescribe oral anti-inflammatories, pain medication, corticosteroid injections, or some combination of these remedies.
If these treatments are not enough, two surgical options are available: