Frozen Shoulder

Shoulder Surgeons in Orange County

Frozen shoulder (adhesive capsulitis) is a condition affecting the shoulder joint that involves the gradual development of pain and stiffness which can worsen over time. The condition may also gradually dissipate over 1 to years, or require treatment and surgery.

The shoulder is a ball-and-socket joint comprised of three bones – the collarbone (clavicle), shoulder blade (scapula), and upper arm (humerus) – held in place by surrounding tissue known as the shoulder capsule. When patients suffer from frozen shoulder, the shoulder capsule thickens and becomes tight, making it difficult to move. Scar tissue and less synovial fluid, which keeps the shoulder joint lubricated, can also further decrease mobility.

Common symptoms associated with frozen shoulder include pain, stiffness, and decreased or severely limited shoulder mobility, as well as pain in the shoulder muscles along the top of the arm. Pain can also become worse at night, making it difficult to sleep. Patients with frozen shoulder typically experience three phases of the condition:

• Freezing stage – Patients will develop pain when moving the shoulder that becomes progressively worse, disrupts sleep, and limits movement. The freezing stage may last anywhere from 6 to 9 months.
• Frozen stage – Pain may dissipate, but stiffness can become more severe and cause limited movement that hinders daily activity. The frozen stage can last as long as 1 year.
• Thawing stage – Over time, and between 6 to 12 months, range of motion in the shoulder may begin to improve.

The underlying cause of frozen shoulder is not known, though can occur secondary to a minor injury. People between 40 to 60 years of age, conditions that prevent or restrict arm movement (such as a stroke), and problems such as diabetes, heart disease, and Parkinson’s can increase risks of developing the condition.

Diagnosing Frozen Shoulder

Physical examinations can allow doctors to determine the extent of pain and decreased movement experienced by patients, and may be sufficient to diagnose the condition. However, doctors may also use anesthetic to numb pain and better assess the shoulder’s range of motion, or use imaging diagnostic tests such as X-rays, MRIs, and ultrasound to identify other potential causes of pain and reduced mobility, including medical conditions like arthritis and rotator cuff injuries.

Treatment Approaches

Treating frozen shoulder will vary from patient to patient depending on the extent of pain, range of motion, and other conditions that may be present. Generally, treatments will begin wi non-surgical approaches and may progress to surgical treatment when symptoms are severe or do not improve over time.

Treatment for frozen shoulder may include:

• Conservative Care & Physical Therapy– Nonsteroidal anti-inflammatory drugs to reduce inflammation and relieve pain, or pain medications, in addition to physical therapy stretching and strengthening exercises to improve range of motion. This may be combined with a cortisone injection to reduce the pain and allow the patient to perform physical therapy with reduced discomfort.
• Shoulder Manipulation – Shoulder manipulation may be performed under general anesthesia to manually manipulate the shoulder, loosen scar tissue, and increase range of motion.
• Surgery – When non-surgical care and physical therapy do not improve symptoms,shoulder surgery may be suggested. This may include a minimally invasive arthroscopic surgery (shoulder arthroscopy) involving the use of small medical instruments inserted through tiny incisions around the shoulder. Physical therapy can also be used following surgery to maintain range of motion. Recovery can range from 6 weeks to 3 months. As a less invasive procedure than open shoulder surgery, arthroscopy can allow for faster recovery and less pain.

Treat Frozen Shoulder with Award-Winning Orthopedic Care

The orthopedic surgeons at Hoag Orthopedic Institute are fellowship-trained to treat shoulder pain and injuries, including frozen shoulder. Additionally, our team of physical therapists, nurses, and staff at advanced and state-of-the-art facilities to make our orthopedic practice one of the most trusted and one of the highest rated orthopedic-only care providers in the nation. Learn more about diagnosing and treating frozen shoulder in Orange County by visiting our online physician directory to find a shoulder surgeon.