Frozen shoulder is a tightening of the shoulder joint. It results in a loss of movement and pain at the shoulder joint. In frozen shoulder: • Active range of motion is lost—You cannot move your shoulder well. • Passive range of motion is lost—Someone trying to move your arm at the shoulder joint will find it stiff and difficult to move. This condition may get worse over time. After a period of time, the shoulder may also improve spontaneously. This improvement is called thawing.
Frozen shoulder is caused by tightening of the soft tissues. This includes the capsule that surrounds the joint. The cause of the tightening is usually not known.
Factors that increase your risk for frozen shoulder include:
Disc problems in your neck
Injuries to the shoulder
Illness or injury that forces you to keep the shoulder immobile for a period of time
Heart and/or lung disease, during which time you do not move the shoulder normally
Significantly reduced movement of the arm at the shoulder joint, when moved by either yourself or by someone else
The doctor will ask about your symptoms and medical history and perform a physical exam. The doctor will test the range of motion in your shoulder. Testing may include:
Treatment focuses on:
Restoring function and range of motion to the shoulder
Pain relievers (such as ibuprofen and aspirin)—to help reduce inflammation and relieve pain.
Muscle relaxants—to help relax arm and shoulder muscles.
Physical therapy—to stretch muscles and restore motion and function to the shoulder. This is the foundation of treatment. It requires home exercise.
Heat and ice therapies—to help relieve pain and reduce swelling.
Corticosteroid injections—as prescribed and given by your doctor (rarely done for this condition).
Closed manipulation surgery is a forceful movement of the arm at the shoulder joint. It is done to address the stiffness. The surgery is performed under anesthesia. The procedure is followed by intensive physical therapy. Be sure to follow your doctor's instructions after surgery.
In arthroscopic surgery, a small incision is made in the shoulder. Special small instruments are inserted through the incision. The tightened tissues are released and the shoulder is manipulated. Physical therapy must be done after this procedure. Be sure to follow your doctor's instructions after surgery.
Capsular distension is often done as a combination of an arthrogram and corticosteroid injection. The doctor expands the shoulder joint by injecting salt water under pressure. The fluid may contain cortisone and may also contain a dye that allows the shape and character of the shoulder joint to be seen on a CT Scan or MRI. If you are diagnosed with a frozen shoulder, follow your doctor's instructions.
To help prevent frozen shoulder:
Do regular strength training and range-of-motion exercises. This will help maintain a strong and flexible shoulder joint.
Seek prompt treatment for a shoulder injury.
Do activities that use your shoulder joint regularly.
After injury to an upper extremity (such as, hand, wrist, elbow), always move the shoulder through a full range of motion several times a day. This is true even when lying in bed for an illness such as a lung infection.
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