Frozen Shoulder: What It Is, Effective Treatments, and Pain Relief Strategies
Frozen shoulder or adhesive capsulitis
Frozen shoulder, or adhesive capsulitis, is a condition that causes pain, stiffness, and limited movement in the shoulder joint. It develops when the connective tissue surrounding the shoulder (called the capsule) becomes inflamed and thickened, restricting movement. Unfortunately, we at Living Well Physical Therapy have seen an up-tick in these cases as of recent, but don’t fret, we are here to offer you relief and improved function!
What Are the Symptoms?
Frozen shoulder typically progresses in three stages:
Freezing Stage (Painful Stage):
Gradual onset of shoulder pain, especially at night or during movement.
The range of motion starts to decrease.
Frozen Stage (Stiffening Stage):
Pain may reduce, but stiffness becomes worse.
Everyday tasks like reaching overhead or behind your back become difficult.
Thawing Stage (Recovery Stage):
Stiffness improves, and shoulder movement gradually returns to normal.
Full recovery may take months to several years. Physical therapy can help speed the healing time.
What Causes Frozen Shoulder?
The exact cause isn’t always clear, but several factors increase your risk:
Injury or Surgery: Shoulder injuries or surgeries may trigger frozen shoulder if the joint isn’t moved enough.
Medical Conditions: Diabetes, thyroid disorders, and heart disease are linked to a higher risk.
Age and Gender: It is more common in people aged 40–65 and affects women more often than men.
How Is It Treated?
Treatment focuses on relieving pain and restoring mobility, then strength. Common approaches include:
Physical Therapy:
Stretching Exercises: To improve flexibility and restore range of motion. There are specific exercises in order to progress mobility, and as physical therapists we know many modifications to make sure you are stretching the muscle effectively.
Strengthening Exercises: Often people have significant decreases in shoulder and shoulder blade strength, physical therapy is necessary to rebuild shoulder strength and function.
A physical therapist will guide you through movements tailored to your stage of recovery.
Manual therapy, and specifically joint mobilizations can improve the capsule and therefore your shoulder mobility.
Dry needling can decrease the tension in muscles around the shoulder which are limiting motion. There is a study that suggests trigger points in the subscapularis contribute to the motion limitations.
Medications:
Over-the-counter pain relievers like ibuprofen or acetaminophen. Evidence supporting the use of nonsteroidal antiinflammatory drugs is limited, but these drugs are often prescribed to provide short-term pain relief in the high-irritability stage. Oral corticosteroids have been shown to improve pain, especially at night and to improve shoulder motion.
Corticosteroid injections may reduce severe inflammation (think not being able to raise your arm to comb your hair or needing some one to help you put on your coat.) Patients with high pain and tissue irritability may benefit from corticosteroid injections to tolerate physical therapy better. These injections, when given in combination with physical therapy, have been shown to lead to greater short-term improvements in pain and self-reported function than physical therapy alone.
What Can You Do at Home
Stay Active: Consistently completing stretches and exercises as advised by your physical therapist.
Be Patient: Frozen shoulder improves over time, though the process may be slow.
Prevent Recurrence: Keep your shoulder moving as much as possible after recovery, especially if you’ve had a previous injury.
Conclusion
Frozen shoulder can be frustrating, but with a combination of physical therapy, home exercises, and patience, most people regain full function. If you have concerns or questions, your physical therapist at LivingWell Physical therapy is here to help guide you through the process.