Frozen Shoulder: Causes And Symptoms

frozen shoulder

Ramnath is a 50-year-old man who works in an automobile manufacturing company.  Off late, he has been experiencing a dull pain in his shoulder region which in some cases spreads over his right arm. He has been trying out all the natural remedies and massages to ease the dull pain but in vain. Now the pain has started to interfere with his work. He is not able to move his hand upwards as the pain intensifies. When consulted by his family doctor, he was diagnosed with a condition known as frozen shoulder. 

Frozen shoulder is not a common condition and most of us might have heard the term for the first time. But according to a study published online[1], the incidence of this condition is seen in approximately 3% to 5% of the general population. Moreover, if you have diabetes, then the risk can increase to as high as 20% as compared to nondiabetics[1]. Medically termed as adhesive capsulitis, frozen shoulder can be treated with medications and physiotherapy sessions. But if you are wondering what is frozen shoulder and whether you are at risk of it or not, then here is what you need to know. 

What Is Frozen Shoulder?

Frozen shoulder is an extremely painful and debilitating condition leading to stiffness and disability of the shoulder. Our shoulder is made up of connective tissues, bones, tendons, and ligaments. When the tissues in the shoulder joint become thicker and tighter, it can cause scarring of the tissue and also impairs the mobility of the joint. In some cases, loss of synovial fluid (which acts as a lubricant) in the joint area can increase the friction and pain. As a result, scarring and inflammation may develop in the shoulder joint that leads to frozen shoulder. 

The common symptoms of this condition include swelling, pain, and stiffness. People above the age of 50 are more likely to have shoulder pain because of weakening of the joints and tissues and decreased immune function[2]. The condition usually affects only one shoulder but there is a high chance that people who suffer from frozen shoulder on one side can develop it on the other side as well. The condition may improve on its own in a span of one year to three years but it can affect mobility and lead to severe pain which requires treatment. The condition occurs more often in women than in men, although the exact reason for this is not yet known.

Causes Of Frozen Shoulder

The exact cause of frozen shoulder is not yet understood but it is believed to occur when the shoulder joint becomes inflamed causing the tissues in and around the joint to shrink and harden affecting the mobility. Moreover, it is a condition that occurs over a course of time meaning you will not get frozen shoulder overnight. It occurs slowly and gradually but can get worse if you suffer from any other health problems such as diabetes or heart disease.

There are certain factors which can up the risk of the condition. The factors can jointly contribute to the inflammation of the tissues near the shoulder joint[1]. The roots of frozen shoulder condition can be traced to conditions such as 

-Diabetes

-Cardiovascular diseases

-Stroke

-Parkinson’s disease

-Thyroid disease

-Hormonal imbalance 

-Weakened immune system

Another major reason for shoulder pain and frozen shoulder is inactivity from a long period. This could be attributed to illness, injury or surgery because it can limit your shoulder movement to a great extent and hence, up your risk of frozen shoulder.

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Symptoms of Frozen Shoulder

If you find it painful to move your shoulders or if your shoulder pain is limiting your movement, then it is most likely that you suffer from frozen shoulder. Pain in the shoulder and restricted mobility of the shoulder are one of the key signs and symptoms of frozen shoulder. You realize you have a frozen shoulder only when the shoulder starts hurting. Your range of arm movement is restricted, and the pain increases gradually over time making your shoulder stiffer day by day. It becomes very difficult to do everyday tasks that involve stretching your shoulder. These include activities such as grabbing objects from a shelf located high in the kitchen or applying soap on your back while taking a bath. You realize that your condition has worsened when you cannot lift your arm to wear your clothes. 

There are three main stages of the frozen shoulder and the treatment approach is based on the severity and the stages of the condition. These include[3]:

Stage 1: Freezing

The beginning of the shoulder pain is the freezing stage during which your range of movement gets restricted. It typically lasts for 6 weeks to 9 months. It causes a gradual increase in the intensity of the pain with movement but the pain remains fairly constant.

Stage 2: Frozen

In this stage, there is a reduction in the severity of the pain. However, stiffness of the shoulder increases, which in turn, limits your ability to perform even the daily tasks involving shoulder movement. It may last for around 4 months to 12 months. 

Stage 3: Thawing stage

This is the stage in which the shoulder motion improves slowly, and it comes back to normal condition at the end of the thawing stage. It can last from 6 months to anywhere till 2 years. 

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Frozen Shoulder: Points To Keep In Mind

-Identifying the signs and symptoms of frozen shoulder during the early stages will ensure that you get timely and appropriate treatment for shoulder pain and immobility. 

-The diagnosis of frozen shoulder is based on the symptoms experienced followed by a physical examination of the shoulder by an expert. So if you experience any symptoms of frozen shoulder, then it is wise to consult a doctor at the earliest and get it treated before it starts to hinder your daily activities.

-Do not self-medicate because it is important to know the cause of it for the right treatment. Home remedies might help for a short time but getting to the root cause is the key to get relief from shoulder pain and frozen shoulder. 

-Although the condition improves with time, your doctor might prescribe painkillers and steroids to reduce pain and inflammation respectively. 

-The use of ice packs or cold packs to ease the pain is also advised to fight pain. In some cases, stretching exercises and physiotherapy is recommended to improve joint mobility.

(The article is reviewed by Dr. Swati Mishra, Medical Editor)

Recommended Reads:

Know Your Medicine: Types of Painkillers

6 Easy Tips To Get Relief From Back Pain And Stiffness

References:

1. Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017 Apr;9(2):75-84.

2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Frozen shoulder: Overview. 2008 Sep 18 [Updated 2018 Jul 12].

3. Rangan A, Goodchild L, Gibson J, Brownson P, Thomas M, Rees J, Kulkarni R. Frozen Shoulder. Shoulder Elbow. 2015 Oct;7(4):299-307. 

4.  Frozen Shoulder – Adhesive Capsulitis – OrthoInfo – AAOS [Internet]. orthoinfo.aaos.org. 2018 [cited 27 September 2018].

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