Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder is when pain and stiffness make it hard to move your shoulder normally. This condition is also called adhesive capsulitis.

The shoulder is a ball-and-socket joint. The ball on the upper arm bone fits into a socket on the shoulder blade. The joint is covered by strong connective tissue called the shoulder capsule.

If the shoulder capsule becomes inflamed and swollen, movement is painful. Bands of scar tissue form on the joint’s surface. This limits your shoulder's range of motion.

In most cases, only one shoulder at a time is affected. Some people may get frozen shoulder in the other shoulder, at a later time.

Frozen shoulder develops slowly in 3 stages. Each stage can last a few months or longer:

  1. Painful stage. Pain occurs when raising your arm up or to the side, or when reaching behind your back. Your range of motion decreases. The pain may be worse at night and keep you from sleeping.

  2. Frozen stage. The shoulder may be less painful, but it's stiffer. Range of motion is very limited.

  3. Thawing stage. Range of motion starts to improve with treatment.

Experts don’t know what causes frozen shoulder. It may occur after an injury such as a fracture. Or it may happen if the shoulder is immobile for a long time, such as after surgery. It may also be an autoimmune response. Risk factors include being over age 40, or having diabetes, heart disease, lung disease, or an overactive thyroid.

The diagnosis is made by physical exam and an X-ray of the shoulder joint. Sometimes an MRI is done to look for other causes.

Mild cases may be treated with a home exercise program and anti-inflammatory medicines. More severe cases require physical therapy. In some cases a steroid is shot (injected) into the shoulder area. In hard to treat cases, forced movement of the shoulder is done while you're asleep under general anesthesia. This will break up scar tissue and increase your range of motion. In rare cases, surgery may be needed to remove the scar tissue. Over time, most people with frozen shoulder get back nearly all range of motion without pain. Recovery may take a few months up to 1 year. You may still feel some stiffness.

Home care

  • If physical therapy was prescribed, keep up with any home exercise program you were given.

  • Keep using the affected shoulder and arm as much as possible.

  • You may use over-the-counter pain medicine to control pain, unless another pain medicine was prescribed. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may work better than acetaminophen. Talk with your healthcare provider if you have long-term (chronic) liver or kidney disease before using these medicines. Also talk with your provider if you've ever had a stomach ulcer or digestive bleeding, or take blood thinners..

Follow-up care

Follow up with your healthcare provider as advised. Or follow up sooner if pain increases or your shoulder motion decreases.

If X-rays or an MRI were done, you'll be told of any new findings that may affect your care.

When to get medical advice

Call your healthcare provider right away if any of these occur:

  • Your shoulder is red or swollen

  • Your arm feels weak or numb

  • Your shoulder movement decreases

  • Your shoulder pain increases even after using pain medicines

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