Your shoulder is a little sore, so you rest it. But instead of getting better, it gets worse. In a few weeks, putting your shirt on or twisting a doorknob is agony. Over time, your shoulder may get so stiff that you can only lift your arm a few inches in any direction.
This is called "frozen shoulder," or adhesive capsulitis. If you don't use your shoulder joint due to injury or illness, it can stiffen up. The ligaments get less stretchy and bands of tissue (adhesions) forms. This makes it painful or impossible to use the joint.
Early diagnosis and treatment is the key to restoring good range of motion.
What causes frozen shoulder?
Frozen shoulder is often the result of an injury or illness that prevents you from fully using your shoulder. It can develop along with bursitis or tendonitis of the shoulder, or a condition that leaves you immobile, such as a stroke. Or, it can occur for no known reason.
Frozen shoulder is most common in people older than 40 and those who have chronic diseases like diabetes or thyroid disease. For reasons that aren't clear, it affects women much more often than men.
How is it diagnosed?
A doctor can usually diagnose frozen shoulder by doing a physical exam and asking about your symptoms. You might need to have an x-ray or MRI to find the cause of your symptoms, such as arthritis or a rotator cuff problem.
How is a frozen shoulder treated?
The goal is to restore the shoulder joint's normal range of motion. To achieve that, treatment often starts with:
- Anti-inflammatory medicines such as ibuprofen or naproxen to reduce pain and swelling in the joint. Ask your doctor before you take any over-the-counter medicines.
- Heat applied to the shoulder.
- Physical therapy to stretch and loosen the joint.
Your doctor or physical therapist can teach you gentle stretching exercises to do at home. It's important to do these on a regular basis. Using a cold pack after you exercise can help reduce soreness. If pain keeps you from exercising, your doctor may give you a corticosteroid shot in the shoulder. This may help reduce inflammation and make movement easier.
If your shoulder doesn't get better, your doctor may manipulate your shoulder while you are under the effects of anesthesia. You are given anesthesia to put you to sleep, then the doctor moves your shoulder through its full range of motion. This breaks up adhesions in the joint and makes it easier to do your exercises.
If other treatments fail, surgery can be done to remove the adhesions in the shoulder. But this is generally not needed.
Once your shoulder is better, be sure to do range-of-motion exercises with both arms. This can keep the same problem from occurring in your other shoulder.
Created on 02/21/2008
Updated on 08/30/2011
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Shoulder problems.
- Sheridan MA, Hannafin JA. Upper extremity: Emphasis on frozen shoulder. Orthopedic Clinics of North America. 2006;37(4): 531-539. Accessed December 17, 2007.
- Nirschl RP, Willett SG. Adhesive capsulitis. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2002. Philadelphia, PA: Hanley & Belfus, Inc.