Frozen Shoulder

Did you know?

•    Frozen shoulder affects 2-5% of the population
•    Frozen shoulder is common among diabetics
•    Frozen shoulder syndrome can be hereditary
•    The condition can last for up to 30 months or more

Causes of frozen shoulder

Frozen shoulder, sometimes referred to as frozen shoulder syndrome, is caused by the soft tissue capsule around the shoulder joint becoming think and swollen. The shoulder joint is a ball and socket at the top end of the humerus bone that sits within the scapula (shoulder blade). The capsule stretches when the arm is raised and hangs as a pouch when the arm is down.

Scar tissue forming in the shoulder capsule causes it to thicken and become tight and swollen leaving less room for the humerus bone in the joint and making movement painful and stiff. Why a frozen shoulder occurs is not fully understood and not always possible to identify but there are a number of known factors that increase the risk of the condition.

Injury to the shoulder (such as a break) or surgery to the shoulder can potentially lead to frozen shoulder syndrome due to the arm being immobile for long periods leading to tightening in the capsule from lack of movement.

Diabetes increases the risk of frozen shoulder syndrome and diabetics are 2-4 times more likely to suffer frozen shoulder, often in both shoulders with more severe symptoms than someone who doesn't have diabetes.

A condition known as Dupuytren's Contracture increases the risk of developing frozen shoulder. The condition causes the fingers to curl into the palm of the hand due to connective tissue in the palm becoming thicker and shortening.

Other health conditions that increase the chances of frozen shoulder include Parkinson's disease, stroke, heart/lung disease and  and hyperthyroidism (overactive thyroid gland).

Symptoms of frozen shoulder

The common symptoms of frozen shoulder are pain in the shoulder joint and restricted movement. Carrying out normal activities such as getting dressed, driving and sleep can be made difficult by a frozen shoulder and cause discomfort. Occasionally, the shoulder can completely freeze up hence the name.

Frozen shoulder develops in three stages over a period of months or even years and symptoms vary from person to person.

The three stages of frozen shoulder are:

•    Stage One – Aching or stiffness in the shoulder that becomes painful. Pain is typically worse at night when on one side and can disrupt sleep or make getting off to sleep difficult. Stage one typically lasts 2-9 months.

•    Stage Two – Known as 'adhesive stage' due to stiffness increasing although pain does not get worse in most cases. Muscles can begin to waste due to lack of movement and stage two lasts from 4-12 months.

•    Stage Three – This is the recovery stage of frozen shoulder whereby movement is gradually restored and pain subsides although stiffness and pain can reoccur occasionally. Full mobility in the shoulder may not return but normal day-to-day tasks will be easier to carry out. Stage three of a frozen shoulder can last from 5 months to 3-4 years.

Diagnosis of frozen shoulder

Getting an early diagnosis from your GP for frozen shoulder will help to prevent chronic stiffness and pain in the shoulder joint and lead to a quicker recovery. A GP will carry out a physical examination of the shoulder and question you about the symptoms.

The physical examination will typically involve your GP assessing your range of movement in the affected shoulder by getting you to move and stretch the arm and shoulder as far as possible. The GP may also manipulate the shoulder themselves which can be uncomfortable but will act as an indicator to how painful the condition is.

Your GP may also apply pressure to the shoulder to see where the pain is localised and what could be the cause of the problem. If necessary, you may be sent for an X-Ray or MRI scan to rule out other problems or damage within the shoulder.

Related frozen shoulder terms

Scapula
Bursitis
Inflammation
Mobility
Stiff shoulder
Adhesive capsulitis
Joint pain
Muscular pain
Rotator cuff
Tendinitis
Fibrous tissue