What is Frozen Shoulder?

Frozen shoulder, or Adhesive Capsulitis, is a condition most commonly seen in adult females, ages 40 to 60. People with diabetes or those who have had their shoulder immobilized for a period of time are also at higher risk of developing frozen shoulder. Thickened bands of tissue or adhesions develop, and there is a decrease in joint fluid, which causes a shoulder to freeze. Typically, symptoms often begin with mild pain and stiffness in the joint. As the shoulder capsular tissue thickens and tightens, range of motion decreases and pain increases. In severe cases, the shoulder can become completely immobile. Dr. Cunningham is a shoulder specialist at Vail Summit Orthopaedics and Neurosurgery. He is an expert at diagnosing and treating frozen shoulder for patients in Vail, Summit County, Aspen, and Denver, CO.

What are the First Signs of Frozen Shoulder?

Initially, the shoulder becomes increasingly painful and range of motion starts to be limited. Typically, pain is localized along the outer aspect of the shoulder, with the pain occasionally radiating down to the upper arm.

What Does Frozen Shoulder Feel Like?

Frozen shoulder is one of the most painful shoulder conditions. The pain is most intense in the early stages as there is severe inflammation in the shoulder joint. The inflammation may be the result of a contributing disease or injury, or it could derive from a period of shoulder immobility.  The pain is often severe and sharp. It typically occurs at the front, back, and side of the shoulder and for some patients the pain radiates into the upper arm. Typically, the pain is lessened if the arm is held at one’s side. However, even small movements of the shoulder and arm can exacerbate the pain.

Limited range of motion and pain impedes patient’s ability to perform activities of daily living such as putting a coat on or fastening a seatbelt. A hallmark symptom of frozen shoulder, compared to other shoulder conditions, is the inability of either the patient or another person to move, lift, or reposition the arm and shoulder because the shoulder joint has become stuck or frozen. In other conditions, such as a rotator cuff tear, another person can likely lift or reposition the arm.

How Does Frozen Shoulder Occur?

The causes of a frozen shoulder are not fully understood. Patients often don’t recall a specific injury, but they may report having recently done a lot of overhead activities or a new exercise that seems to coincide with the beginning of their symptoms.

Frozen shoulder has three stages:

  • Stage I – Freezing: During the freezing stage, patients notice dull achiness in the shoulder and a mild reduction in range of motion. As the freezing period continues, both the pain and stiffness increase. The freezing stage can last for 2 to 9 months, worsening over time. Nighttime pain may become prevalent.
  • Stage II – Frozen: Marked by a reduction in pain, this is the stage of frozen shoulder in which movement of the shoulder is very limited. Daily tasks may be difficult to accomplish, and patients are somewhat disabled during this stage of the condition. The frozen stage can last from 4 to 6 months.
  • Stage III – Thawing: This is the recovery stage, when the condition of frozen shoulder begins to heal. The inflammation of the shoulder joint and capsule begins to decrease. Shoulder motion slowly improves during the thawing stage. Pain lessens and may entirely resolve but some are left with mild pain. Range of motion of the shoulder improves and may return to normal. The thawing stage can take from 6 months to 2 years for a complete resolution.

How to Cure Frozen Shoulder Quickly?

It is important to diagnose and treat the condition as early as possible. The longer symptoms are left untreated, the greater the probability of developing stage II frozen shoulder and all the ensuing symptoms. Some home remedies can help patients who suspect that a frozen shoulder may be developing. These treatments include:

  • Ice and Heat Therapy: For pain management, heat or ice therapies, or alternating both, can provide relief. A hot compress or heating pad can be applied several times a day for 15 minute intervals. Likewise, an ice pack can also be used for the same time period.
  • Pain Management: Inflammation of the shoulder’s soft-tissues can be minimized with the regular use of an anti-inflammatory medication. This will also assist with pain reduction.
  • Physical Therapy: Performing gentle range of motion and shoulder strengthening exercises may prevent the condition from progressing. We recommend that an exercise plan be discussed with a medical professional in order to avoid activities that may worsen the condition.

If home remedies do not improve symptoms or if pain and stiffness worsen, orthopedic evaluation and treatment is recommended. Non-surgical treatments such as a steroid injection placed into the shoulder joint may be considered in an attempt to arrest and possibly reverse the course of a frozen shoulder.

If the inflammation, pain, and stiffness worsen despite a good course of non-surgical management, surgical intervention may be considered. In surgery, an anesthesiologist would typically do a nerve block immediately before surgery and then administer a light general anesthetic during surgery. Dr. Cunningham would then place an arthroscope into the shoulder joint with two or three small incisions being made. Using a small electrocautery device, the thickened adhesions are precisely released and any bleeding is minimized. The shoulder is then gently brought through a full range of motion once the adhesions have been released thus restoring full motion to the shoulder. The upper extremity is placed in a sling for comfort, but patients are encouraged to come out of the sling the same day and start gentle range of motion exercises and physical therapy within 1-2 days of surgery. Patients go home the same day and then follow up with Dr Cunningham in 7-10 days. For many patients, a combination of both shoulder arthroscopy and joint manipulation can provide an optimal result. In all cases, the quickest way to recover from a frozen shoulder condition is to treat it early and comprehensively, with expert orthopedic care.

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When Does Frozen Shoulder Go Away?

Depending on the severity of the condition, a frozen shoulder may resolve on its own in 1 to 3 years. The sooner treatment begins, the sooner recovery is achieved. A chronic, untreated frozen shoulder is more challenging to resolve without surgery. The key is early recognition of the condition and immediately beginning a comprehensive treatment plan, in order to minimize the duration of the condition and return to the shoulder to normal health and function. Dr. Cunningham is a shoulder specialist at Vail Summit Orthopaedics and Neurosurgery. He is an expert at diagnosing and treating frozen shoulder for patients in Vail, Summit County, Aspen, and Denver, CO. Contact Dr. Cunningham today.

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