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, includingmedical
conditions like arthritis and rotator cuff injuries.
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.
Treatmentfor 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 shouldersurgery, 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.