Frozen Shoulder (Adhesive Capsulitis)

What is a frozen shoulder?

A frozen shoulder is stiffness and pain in the shoulder.

How does it occur?

A frozen shoulder usually develops after a shoulder injury that causes pain and does not allow you to move your shoulder enough. Sometimes, however, a frozen shoulder may occur for no known reason. If you have limited movement of your shoulder for weeks, months, or years because of an injury, the capsule surrounding the shoulder joint may become very stiff. Your shoulder may develop scar tissue, or adhesions, in the joint.

What are the symptoms?

Your shoulder will lose its normal ability to move in all directions. You may not be able to lift your arm above your head or be able to scratch your back. Movement of the shoulder may be very painful. You may feel grinding when moving your shoulder.

How is it diagnosed?

Your healthcare provider will examine your shoulder and may take X-rays. You may also have an MRI (magnetic resonance imaging). In some cases, you may have an arthrogram (an X-ray or an MRI of your shoulder after dye is injected into your shoulder joint).

How is it treated?

Your healthcare provider will probably send you to physical therapy for a supervised exercise program. You will also be given exercises to do at home. Your provider may prescribe an anti-inflammatory medicine and may give you a shot of a corticosteroid medicine into your shoulder joint. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider's approval. When your shoulder is painful, it is important to use ice packs on your shoulder for 20 to 30 minutes 3 or 4 times a day.

In cases that do not respond to therapy, your provider may talk to you about doing a "manipulation under anesthesia." In this procedure, you are put to sleep with a general anesthetic and your provider moves your shoulder in various directions to break up the adhesions (bands of scar tissue) in your shoulder capsule. You may need arthroscopic surgery to see if there are other causes for your frozen shoulder.

How long will the effects last?

The length of recovery depends on many factors such as your age and health, and if you have had a previous shoulder injury. The effects of a frozen shoulder can be long lasting and can gradually worsen if you do not have appropriate treatment. Since a frozen shoulder can be caused by several factors it is important that these be corrected.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your shoulder recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your normal activities when:

• Your injured shoulder has full range of motion without pain.
• Your injured shoulder has regained normal strength compared to the uninjured shoulder.

How can I prevent a frozen shoulder?

After you have had an injury to your shoulder it is important that you do not limit your shoulder motion for a prolonged period of time. It is important to do your shoulder rehabilitation exercises as they have been prescribed. If you feel that you are losing range of motion in your shoulder you should see your healthcare provider.