Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms begin gradually, worsen over time and then resolve, usually within a two-year period.

Symptoms

Frozen shoulder typically develops slowly, and in three stages. Each of these stages can last a number of months.

* Painful stage. During this stage, pain occurs with any movement of your shoulder, and your shoulder's range of motion starts to become limited.
* Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and your range of motion decreases notably.
* Thawing stage. During the thawing stage, the range of motion in your shoulder begins to improve.

For some people, the pain worsens at night, sometimes disrupting normal sleep patterns.

Causes

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.

Risk Factors

Although the exact cause is unknown, certain factors may increase your risk of developing frozen shoulder.

Age and sex
People 40 and older are more likely to experience frozen shoulder. About 70 percent of the people who develop the condition are women.

Immobility
People who have experienced prolonged immobility of their shoulder are at higher risk of developing frozen shoulder. Immobility may be the result of many factors, including:

* Rotator cuff injury
* Broken arm
* Stroke
* Recovery from surgery

Systemic diseases
People who have certain medical problems appear to be predisposed to develop frozen shoulder. Examples include:

* Diabetes
* Overactive thyroid (hyperthyroidism)
* Underactive thyroid (hypothyroidism)
* Cardiovascular disease
* Tuberculosis
* Parkinson's disease

Treatment and drugs

Most frozen shoulder treatment involves controlling shoulder pain and preserving as much range of motion in the shoulder as possible.

Medications

* Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications may help relieve pain and inflammation associated with frozen shoulder. Acetaminophen (Tylenol, others) also may be effective for pain relief.
* Corticosteroids. Injecting these anti-inflammatory medications into your shoulder joint may help decrease pain and shorten symptom duration during the initial painful phase. Repeated corticosteroid injections aren't recommended.

Therapy
A physical therapist can teach you exercises to help maintain as much mobility in your shoulder as possible, without stressing your shoulder to the point of causing a lot of pain.

Surgical and other procedures

* Distension. Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint.
* Shoulder manipulation. In this procedure, you're given general anesthesia and then the doctor moves your shoulder joint in ways that help loosen the tightened tissue.
* Surgery. In a small number of cases, especially if your symptoms don't improve despite other measures, surgery may be an option to remove scar tissue and adhesions from inside your shoulder joint. Doctors usually perform this surgery arthroscopically, with a lighted, tubular instrument inserted through a small incision in your joint.