Understanding frozen shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. Symptoms typically begin gradually, worsen over time and then resolve, usually within one to two years.

“Frozen shoulder can be very frustrating for patients,” says Dr. Brian Gushaty, an Edmonton chiropractor. “Movement of the shoulder is severely restricted and the pain is usually constant. It can make even small tasks, like dressing and brushing your teeth, impossible.”

In addition to difficulty with everyday tasks, people who suffer from frozen shoulder usually find that pain is worse at night, resulting in restricted sleeping positions and poor/disrupted sleep. The condition can lead to depression, pain and issues in the neck and back.

Stages

Frozen shoulder starts with an inflammation of the joint capsule of the shoulder joint. This shoulder joint holds the bones of the joints to each other with ligaments. Inflammation of the ligaments causes shoulder pain and over time restricts range of motion in the shoulder joint. The shoulder becomes frozen and unable to move.
The condition usually develops slowly in three stages. Each stage can last several months. 

  1. Freezing or painful stage: Characterized by slow onset of pain; range of motion becomes increasingly limited.
  2. Frozen or adhesive stage: Pain may begin to diminish during this stage. However, the shoulder becomes stiffer and range of motion decreases noticeably.
  3. Thawing or recovery stage: During this stage the range of motion begins to improve.

Pain due to frozen shoulder is usually dull or aching. For many people the pain worsens at night, resulting in disrupted sleep.

What causes frozen shoulder?

The exact cause of frozen shoulder is unknown, although certain factors may increase risk of developing the condition.

Frozen shoulder more often affects people over the age of 40 and is most common in women. The condition is more likely to affect those who have recently experienced prolonged immobilization of the shoulder, such as:

  • rotator cuff injury
  • broken arm
  • stroke
  • recovery from surgery

Diagnosis of frozen shoulder

Frozen shoulder can usually be diagnosed by signs and symptoms alone. Your health care provider will likely ask a number of questions, including:

  • When did your symptoms begin?
  • Are there any activities that worsen your symptoms?
  • Have you ever injured your shoulder? If so, how?
  • Have you had any recent surgeries or periods of restricted shoulder motion?

During the physical exam, your health care provider may also ask you to perform certain movements to assess pain and evaluate range of motion. These may include:

  • Hands up: Raising both hands straight up in the air, like a football referee calling a touchdown.
  • Opposite shoulder: Reaching across your chest to touch your opposite shoulder.
  • Back scratch: Starting with the back of your hand against the small of your back, reach upward to touch your opposite shoulder blade.

Your provider may also suggest imaging tests, such as x-rays or an MRI, to rule out other structural problems.

Treatment for frozen shoulder

Your chiropractor can help in the assessment and treatment of frozen shoulder. “Early treatment for frozen shoulder is the best way to prevent stiffness that can lead to a more severe case of frozen shoulder,” says Dr. Gushaty. “In many cases, early intervention leads to early resolution.”

Treatment usually involves controlling shoulder pain and preserving/restoring as much range of motion in the shoulder as possible. “Chiropractors have a number of effective tools for the treatment of frozen shoulder,” says. Dr. Gushaty.

If you’ve had an injury that makes it difficult to move your shoulder, talk to your chiropractor about the best treatment plan to maintain the range of motion of the shoulder joint and reduce the likelihood of developing frozen shoulder.

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