Written By: Dr Evan Steinke, DC
Frozen shoulder, also known as adhesive capsulitis, is characterized by pain and a progressive loss of motion in your shoulder joint. You may have experienced this as beginning with shoulder pain from an unknown cause that made your sleep difficult and became increasingly painful over the coming weeks. Frozen shoulder is caused by inflammation of the shoulder joint resulting in adhesions and stiffening of the surrounding structures. As a result, the shoulder begins to become painful and lose its mobility. This is more commonly seen in people over the age of 40 and is slightly more common among women with both diabetes and thyroid disease being known risk factors.
Frozen shoulder is known to have a particularly long recovery time without treatment of 18-24 months. Due to the long duration of the condition is often divided into three phases.
Phase 1 – Freezing: Pain in the shoulder as it begins to tighten over several months. It may be particularly noticeable at night and progress to being painful at rest.
Phase 2 – Frozen: The structures around the shoulder are now adhered to each other and mobility is limited in most or all directions, however, pain may begin to diminish in this phase. This phase can last for up to a year.
Phase 3 – Thawing: The structures around the shoulder begin to loosen and allow for a gradual return of shoulder mobility over 6+ months.
Your doctor will be able to determine which phase you are in with a physical examination, there is no need for x-rays or other forms of imaging. Management of frozen shoulder depends on the phase you are currently in but will often include a wide range of physical therapy approaches aiming to improve your range of motion and providing relief. These can include the following:
Muscle release techniques: These techniques aim to help ease pain in the surrounding shoulder muscles and reduce muscle tension to allow for improved movement.
Exercises and Stretches: A variety of programs can be performed at home that aim to improve muscle strength, improve flexibility, and provide improved joint stability.
Mobilization: Working with the shoulder joint directly your therapist will help mobilize the joint to improve range of motion.
Activity Modification: Depending on your specific needs your doctor may also make modifications to your daily routines and activities to ease the load and stress on your shoulder joint.
In severe cases that do not respond to conservative care your therapist will be able to evaluate and direct you for a shoulder injection or discuss other options for your particular situation.