Frozen Shoulder
An overview on frozen shoulder (adhesive capsulitis)
Frozen shoulder, otherwise known as adhesive capsulitis, is a condition that can cause a large amount of shoulder discomfort and limited shoulder movement. In many cases, a “stiff shoulder” can result in a complete loss of function and motion of the shoulder joint. Orthopedic shoulder specialist in the Chicago, Westchester, Oak Brook and Hinsdale, Illinois area, Dr. Nikhil Verma is trained and highly experienced in treating frozen shoulder symptoms and returning patients to their daily activities.
Frozen shoulder develops when the soft tissue of the shoulder joint begins to thicken and contract as a result of the formation of scar tissue. The scar tissue, or adhesions, creates the loss of motion. Over time, the shoulder is moved less because of shoulder pain and stiffness becomes worse. The pain and loss of movement can become so severe in some cases that daily activities can become difficult to complete.
The two types of frozen shoulder:
- Primary adhesive capsulitis: This type occurs when a patient gradually experiences a slow loss of shoulder motion for no apparent reason. Possible causes include an inflammatory disease, changes in hormone levels or changes in the immune system. It may often be associated with diabetes or other endocrine disorders such as hypothyroid.
- Secondary adhesive capsulitis: This type occurs from a known cause such as following a shoulder injury, shoulder fracture or previous shoulder surgery.
Frozen Shoulder Symptoms
The hallmark frozen shoulder symptoms are inability to move the shoulder, shoulder weakness and pain. The pain is usually described by patients as a dull or achy sensation. The onset of symptoms may be gradual or sudden.
Frozen Shoulder Diagnosis
After discussing frozen shoulder symptoms and medical history, Dr. Verma will conduct a physical examination of the shoulder. He will move the shoulder in all directions to determine where pain and limited movement is present. An MRI or X-ray may be performed to determine if other conditions are present such as a broken bone, rotator cuff injury or shoulder arthritis.
Frozen Shoulder Treatments
The focus of frozen shoulder treatment is to control pain and restore motion and strength.
Non-Surgical
Physical therapy plays a critical role in treating this shoulder condition. In addition to physical therapy, Dr. Verma will also recommend ice, rest and anti-inflammatory medications. Steroid injections may also be used in some cases. Non-surgical treatments typically take a few months to notice a decreased symptom level.
Surgical
Dr. Verma will perform arthroscopic surgery if non-surgical treatments are not diminishing frozen shoulder symptoms. Arthroscopic shoulder surgery is used to release tight areas and then remove scar tissue around the shoulder to relieve pressure. Dr. Verma may recommend an open surgical approach in the most severe frozen shoulder cases. Following surgery, aggressive physical therapy is required to maintain motion along with home exercises for stretching.
How do you diagnose a frozen shoulder?
After discussing frozen shoulder symptoms and medical history, Dr. Verma will conduct a thorough physical examination of the shoulder. He will move the shoulder in different directions to determine where pain and limited movement is present. An MRI or X-ray may be performed to determine if other conditions are present such as a broken bone, rotator cuff injury or shoulder arthritis.
What is the main cause of frozen shoulder?
Frozen shoulder develops when the soft tissue of the shoulder joint begins to thicken and contract as a result of the formation of scar tissue. The scar tissue, or adhesions, creates the loss of motion. Over time, the shoulder is moved less because of shoulder pain and stiffness becomes worse. The pain and loss of movement can become so severe in some cases that daily activities can become difficult to complete.
Can myofascial release help frozen shoulder?
Myofascial release targets the fascia: the protective membrane that protects the muscles, blood vessels and organs in your body. When the movement of the fascia is restricted, it is impossible to move without pain. A special type of massage therapy called trigger point therapy can sometimes be effective in treating a frozen shoulder. Dr. Verma recommends ice, rest and anti-inflammatory medications. Steroid injections may also be used in some cases to help frozen shoulder.
How to release a frozen (Stiff) shoulder?
If non-surgical treatments do not alleviate pain and restore the shoulder to full mobility, Dr. Verma will perform arthroscopic surgery. Arthroscopic shoulder surgery is used to release tight areas and then remove scar tissue around the shoulder to relieve pressure. Dr. Verma may recommend an open surgical approach in the most severe frozen shoulder cases. Following surgery, aggressive physical therapy is required to maintain motion along with home exercises for stretching.
How long does it take for a frozen shoulder to heal?
Frozen shoulder symptoms have three phases:
- Freezing – Shoulder pain that worsens over time and the shoulder loses range of motion. Can last 6 weeks to 9 months.
- Frozen – Painful symptoms sometimes improve during the frozen phase, but stiffness remains. Daily activities can be difficult
- Thawing – Shoulder motion finally improves during this phase. A complete return to normal strength and motion can take 6 months to 2 years.
What are the first signs of frozen shoulder?
Pain and stiffness are the first indicators of adhesive capsulitis. As shoulder pain worsens, range of motion decreases.
What is the best exercise for frozen shoulder?
Dr. Verma can suggest specific physical therapy exercises for the frozen shoulder. It is important to conduct range of motion exercises properly, so the condition does not worsen.
How can I get pain relief from frozen shoulder?
Anti-inflammatory medications or steroid injections – when warranted – can help ease the discomfort of frozen shoulder symptoms. Ice and rest are also recommended as an early at-home treatment for frozen shoulder.
Can frozen shoulder be permanent?
Frozen shoulder is rarely permanent, but it can take months to years to “thaw” without surgical intervention. Dr. Verma can discuss different treatment options as well as new therapies to help with frozen shoulder.
Can neck problems cause frozen shoulder?
Neck problems do not cause frozen shoulder but can be a cause of shoulder pain. It is important to see Dr. Verma and his team for pain in the neck or shoulder. Some neck problems can cause shoulder pain and visa-versa. If a cervical nerve root becomes compressed or irritated in the neck, it can cause pain and symptoms that radiate along the path of the nerve into the shoulder, arm and/or hand.
Will frozen shoulder resolve on its own?
Most cases of frozen shoulder will resolve on its own. Shoulder range of motion may be limited however, as some patients do not gain back their entire range of motion after the thawing phase. Consultation with Dr. Verma and his team can give patients the best chance of regaining full, painless motion.
Dr. Nikhil Verma is a Chicago, Westchester, Oak Brook and Hinsdale, Illinois area orthopedic shoulder specialist. For additional resources on frozen shoulder, please contact his office for a consultation.
