Frozen shoulder is a condition in which the shoulder tightens and becomes difficult to move. It often has no known cause and is more likely to occur in people with diabetes, people with significant scar tissue from shoulder surgery, and people who have kept their arm immobilized for a long period of time. Treatment can help patients with frozen shoulder regain their shoulder function.
Symptoms of a frozen shoulder include:
- Decreased range of motion, particularly when extending the arm out to the side and rotating it
While frozen shoulder can sometimes resolve on its own, many patients will benefit from treatment. The following treatments can help stretch the shoulder, improve range of motion and strength, and prevent persistent stiffness and weakness due to lack of use.
- Physical Therapy: Guided PT is usually recommended for patients with frozen shoulder. Physical therapy can improve strength and range of motion and should be combined with gentle daily stretching exercises at home. A formal PT course is recommended so that progress can be monitored and there is less risk of overstretching (which can sometimes increase inflammation). Patients who undergo shoulder surgery (such as for a rotator cuff tear) can reduce their risk of frozen shoulder by doing PT during their recovery.
- Anti-Inflammatory Medication: Non-steroidal anti-inflammatory medications can decrease inflammation and pain caused by a frozen shoulder. Patients undergoing physical therapy may benefit from taking anti-inflammatory medications (over-the-counter or prescription strength) to reduce pain while they work to regain strength and mobility.
- Injections: Steroid injections may be administered to the shoulder joint to alleviate pain, stop the inflammatory process, and reduce excess scar tissue formation.
- Surgery: For patients who have not had success with conservative treatments, surgery may be recommended. During the surgery, the shoulder is manipulated in various directions to break up the scar tissue, and surgical tools are used to release any scar tissue bands (adhesions) that are restricting motion. The procedure typically lasts about one hour, and patients can usually go home the same day.
Frequently Asked Questions
A frozen shoulder often begins with a trivial shoulder injury, which leads to progressively worsening pain and stiffness. The most recognizable symptoms are noticeably decreased range of motion, pain, stiffness, and weakness, especially in those at higher risk (individuals with diabetes, an immobilized shoulder, or recent shoulder surgery). An MRI may also be performed to reveal any thickening of a scar capsule, which may cause the shoulder joint to tighten.
Many patients do not need to undergo surgery for a frozen shoulder. Surgery is usually reserved for patients who fail to progress with physical therapy, anti-inflammatory medications, and/or injections. Factors including the patient’s age, level of function, rate of progression, and lifestyle demands will all play a role in determining whether surgery should be considered.
Frozen shoulder can sometimes resolve on its own, although this can take many months. Many patients who do not get treatment for their frozen shoulder will have persistent stiffness, weakness, and decreased range of motion. Conservative treatments like physical therapy and steroid injections can significantly speed up the healing process and help patients regain their shoulder function sooner.