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Pretty much everyone has heard of getting the “cold shoulder,” but a frozen shoulder? That's something else entirely. Also called adhesive capsulitis, frozen shoulder is a painful condition that causes significant stiffness in the shoulder joint, limiting your range of motion and making it difficult to perform even simple movements like reaching above your head. Some cases of frozen shoulder occur following an overuse injury or traumatic injury, or as the result of a stroke or other disease that causes the tissues surrounding the joint to become inflamed and stiff. Other times, frozen shoulder symptoms can develop without a specific known cause. In either case, symptoms develop when fibrous bands of scar tissue (or adhesions) form around the joint, causing additional restriction in movement and joint function.

Frozen shoulder symptoms tend to begin slowly, growing gradually worse until even the smallest movements can cause pain, and movement and function become significantly impaired.

Why does frozen shoulder occur?

The specific mechanism that causes frozen shoulder isn't well understood, but we do know how the condition affects the shoulder. A healthy shoulder joint comprises three bones that form a ball-and-socket. The joint is surrounded by strong connective tissue that forms a supportive “capsule” to help hold the joint together and facilitate normal movement. In frozen shoulder, the capsule becomes stiff and thick as adhesions form inside the fibers (hence the name “adhesive capsulitis). Sometimes, the amount of lubricating fluid inside the joint also decreases, increasing friction and inflammation inside the joint.

Frozen shoulder develops in three distinct stages:

  • In the freezing stage, the condition gradually becomes worse, with increasing pain and stiffness and decreasing range of motion in the joint. This stage typically lasts from six to nine months.
  • In the second stage, called the frozen stage, the joint remains stiff, but painful symptoms may begin to resolve. The frozen stage lasts about four to six months.
  • During the third and final stage, thawing, shoulder movement and function slowly improve. Thawing can take up to two years. In some cases, surgery is necessary to remove adhesions so the shoulder is able to “thaw” and heal.

Frozen shoulder can occur in anyone, but it's more common among people between the ages of 40 and 70 years of age, especially postmenopausal women. It's also more common among people with diabetes, thyroid disease, Parkinson's disease and cardiac disease.

How is frozen shoulder treated?

Often, frozen shoulder resolves over time, although healing can take two to three years. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy during this time can help relieve pain and promote greater mobility in the joint, and injections of corticosteroids may also help reduce painful inflammation.

Sometimes, shoulder surgery is required to loosen some of the stiff bands of scar tissue that prevent the joint from moving freely. There are two main types of surgery that can be performed. In the first type, no incisions are used. Instead, the doctor will give you anesthesia to enable you to fall asleep, then the shoulder joint will be gently stretched and moved to loosen the stiff bands of fibrous tissue inside the capsule and joint tissue. The anesthesia enables the joint to be stretched in ways that would otherwise be too painful.

The second type of surgery is called shoulder arthroscopy. In this procedure, the doctor uses small incisions and special surgical instruments to “clean” the area around the joint so mobility and function are improved. In some patients, both approaches may be used in combination to achieve optimal results. Physical therapy for two to three months following surgery helps your shoulder fully recover.

Relieve your shoulder pain and stiffness.

Frozen shoulder is just one cause of persistent shoulder pain and stiffness. To find out what's causing your shoulder symptoms - and how to relieve them and restore your pain-free range of motion - call Dr. Van Thiel with OrthoIllinois at and schedule an evaluation today.

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