Treating a Frozen Shoulder: Adhesive Capsulitis

You might not realize how much you rely on your shoulders for even some of the simplest movements throughout the day. It’s only after you develop a condition like a frozen shoulder that you come to appreciate all that your shoulder normally does.

Still, if you do discover that you have this condition, what do you do? What does treating a frozen shoulder involve, will it go away on its own, and how long will this take?

Let’s find out!

What is a frozen shoulder?

A frozen shoulder is a colloquial term for adhesive capsulitis, which occurs when the capsule of connective tissue surrounding the shoulder joint thickens to the degree that restricts shoulder movement.

In other words, it’s a condition that limits the movement of your shoulder joint. In addition, it usually occurs with gradually increasing pain and stiffness.

It can develop in one or both shoulders.

What are the symptoms of a frozen shoulder?

The symptoms of a frozen shoulder usually occur in three stages.

• First, you have the freezing stage. In this stage, you’ll experience pain whenever you try to move your shoulder. Sometimes, your movement will be restricted, but most of the time, you’ll just avoid moving it to avoid pain. For most of the ten, this stage lasts 2-9 months.
• Next is the frozen stage. Surprisingly enough, at this stage, the shoulder pain lessens but the stiffness increases. This phase can last anywhere from 4 to 12 months.
• The thawing stage is when the shoulder’s ability to move begins to improve. This stage usually lasts 5-24 months.

Once it’s cured, it’s very unlikely that it will develop in the same shoulder again. It could, however, appear in the other shoulder, later on.

What causes a frozen shoulder?

It is unclear why this condition happens, but the most likely explanation is that the stillness of the shoulder over a long period of time might increase the odds of its development. This is why, after a shoulder fracture or shoulder surgery, you might start experiencing these symptoms.

In some occupations, you might keep your shoulder in a still position for hours at a time (like in some tasks requiring manufacturing on an assembly line), causing you to be at a greater risk of developing a frozen shoulder.

There are also some risk factors to be taken into consideration.

For instance, people over the age of 40 are more likely to have a frozen shoulder. Women are also more likely to develop this condition as well.

People with diabetes, overactive thyroid, underactive thyroid, Parkinson’s disease, or cardiovascular disease are also more likely to develop this condition.

Do’s and don’ts for frozen shoulder?

Treatment for frozen shoulder will typically take weeks or months to improve this condition. In the meantime, you need to learn what you should and should not do.

A lot of people find it intuitive to apply some ice to the shoulder; however,you should apply mild heat. A hot tub or a warm shower will be quite helpful instead. Heat will help relax and loosen tissue, as well as stimulate blood flow, all of which are helpful in this condition.

It's important to avoid forcing motion when dealing with an injury. This isn't just a minor obstacle that you can push through, as there may be an active obstacle in your shoulder. Attempting to force mobility could lead to a more serious injury, so it's best to proceed with caution and follow proper medical advice.

One of the worst methods for treating a frozen shoulder is to take too much pain medication. Sure, it hurts, but these meds could harm your stomach, liver, kidneys, and other organs when used excessively. Even with over-the-counter medication, it’s always best to seek treatment from your doctor.

How can you go on about treating a frozen shoulder?

Treating a frozen shoulder can be done in two ways - conservatively or surgically (with the latter being quite rare and usually unnecessary).

Conservative treatment options

Will a frozen shoulder heal on its own?

The condition may resolve itself within 12-18 months; however, it’s always best to ask a doctor for an opinion rather than just to expect things to get better on their own.

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Although frozen shoulder is usually successfully treated without surgery, it can be a frustratingly slow process that requires a lot of patience, and guidance from orthopedists and physical therapists can really help in maximizing outcomes.

William Sayde, MD, Orthopedic Surgeon
The Orthopedic Institute of New Jersey

Your doctor may prescribe a steroid injection, which will improve the motion of the shoulder and reduce the pain. Just keep in mind that this is a decision that a trained professional should make.

Physical therapy always helps, and it’s one of the first things you’ll encounter when researching how to release a frozen shoulder. At the very least, a physical therapist can show you how far you can push yourself with a frozen shoulder and how to use appropriate strengthening exercises without increasing the damage.

Surgical treatments

In this scenario, minimally invasive surgical procedures are utilized. They are also only advised after the conservative treatment has failed to give the desired results.

The first one is manipulation under anesthesia. Here, the doctor puts you under anesthesia and forces the shoulder to move, causing the capsule and scar tissue to stretch or tear. This way, the problem will be resolved while a patient is unconscious, which means that they won’t have to suffer from excruciating pain.

Another solution is a shoulder arthroscopy. This is where the doctor uses a small scope to visualize tight portions of the joint capsule and release them with small cuts using pencil-sized instruments.

How long does a frozen shoulder last?

Usually, it will take between 12-18 months, and it will probably not appear again in the same shoulder. This likely results in some mild discomfort while waiting it out. Still, actively treating it (especially under a doctor’s guidance) will improve the recovery rate and give more consistent results.

Wrap up

Ultimately, treating a frozen shoulder is a long process; fortunately, it’s a condition that usually doesn’t recur in the same shoulder (although there are some exceptions). Ideally, as soon as you suspect you have developed adhesive capsulitis, you should see a specialist and ask for a quote.

In this scenario, you should find an expert in frozen shoulder diagnosis and treatment at the Orthopedic Institute of NJ.