Understanding Frozen Shoulder: What Every Woman Should Know

If you’ve ever woken up with a stiff, painful shoulder that doesn’t move the way it used to, join the club—you might not just be “sleeping on it wrong.” Frozen shoulder is a condition most orthopedic surgeons see quite frequently, and it affects mostly women—about 70% of all cases.

Frozen shoulder does not happen all at once. At first, there may be a little pain or stiffness when reaching overhead or behind your back. But over time, that stiffness increases, and simple things become painful and difficult. What’s happening is the tissue surrounding the shoulder begins to thicken up and tighten as you age, bringing pain. Your body then develops scar tissue which tightens the area even more.

Women are most affected, and frozen shoulder generally shows up between the ages of 40 and 60. Studies note the drop in estrogen that comes with menopause impacts inflammation, connective tissue, and how women experience pain. These all combine into the perfect storm to cause frozen shoulder.

There are many other risk factors, not just menopause. People with diabetes are five times more likely to develop frozen shoulder. Frozen shoulder has also been linked with thyroid conditions and heart disease.

Frozen shoulder is a three-stage process, each of which can last several months. It starts with the freezing phase, when the pain sets in and movement becomes more difficult and then advances into the frozen phase that has reduced pain, but unfortunately more stiffness. The phase sees a slow return of movement.

Treatment usually starts conservatively with physical therapy. I recommend a series of gentle stretching to keep as much range of motion as possible. Ibuprofen and other anti-inflammatory medications help with the pain, too.

It can take time to recover, but it does get better. I always tell my patients: keep your shoulder moving, even if it’s just a little gentle daily exercise. It can prevent the shoulder from tightening. Never stop using the joint entirely or pain and stiffness can increase.

Recognizing the early signs—especially for women nearing or going through menopause—can make a big difference. The sooner we catch frozen shoulder, the easier it is to manage.

Hafiz F. Kassam, M.D., is director of shoulder reconstruction at Hoag Orthopedic Institute