Frozen Shoulder

Frozen shoulder tends to occur after an injury which may be small, or from the overuse of the shoulder. It’s also more common in people with chronic diseases like diabetes. It also can occur after surgery to the shoulder for other problems. It typically occurs in three stages: freezing (pain increases, and range of motion decreases), frozen (pain may decrease, but the shoulder remains stiff), and thawing (movement slowly improves).

People with frozen shoulder may experience:

• Gradual increase in pain, it may become very painful and debilitating at its peak
• Pain severe enough to affect sleep
• Loss of range of motion in the shoulder
• Difficulty with daily activities like dressing, bathing, and eating

Frozen shoulder often improves over time, but the process can take up to two to three years. However, treatment can help reduce pain and improve shoulder mobility more quickly.

Diagnosis of frozen shoulder involves a physical exam to assess pain and range of motion. Your shoulder surgeon Dr. Mayo may also order imaging tests such as X-rays or MRI to rule out other problems.

Treatment options for frozen shoulder typically include:

• Physical therapy: Specific exercises can restore motion and improve flexibility. However, even with proper therapy it can still take over a year for the motion to improve back to normal.
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling.
• Steroid injections: Injections into the shoulder joint can help reduce pain and improve range of motion, particularly if they are done early in the process.

Surgery for frozen shoulder is generally reserved for patients who see little improvement after non-surgical treatments. The timing depends on the individual’s symptoms and response to other treatments. There is no urgency to proceed with surgery, and is generally considered better to wait awhile after the symptoms start to ensure they do not recur after surgery.

Surgery for frozen shoulder usually is performed arthroscopically. Dr. Mayo inserts a small camera into the shoulder joint and uses small surgical instruments to cut through tight portions of the joint capsule. In some cases, manipulation under anesthesia is also performed, where the shoulder joint is moved to help loosen the tightened tissue. Though this portion will help, it is critical to get into physical therapy immediately after surgery to ensure this new range of motion is maintained.

There are two types of frozen shoulder: primary (idiopathic), where the cause is unknown, and secondary, which occurs after injury or surgery to the shoulder.

Recovery from frozen shoulder surgery involves physical therapy to help regain motion and strength in the shoulder. Most people regain full shoulder function within 6 months to 2 years.