Find Frozen Shoulder Specialists near you

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FAQs:

What is a Frozen Shoulder?

Frozen shoulder (adhesive capsulitis) results from the gradual loss of movement in the shoulder (glenohumeral) joint. This joint consists of a ball (the humeral head) and a socket (the glenoid). Normally it is one of the most mobile joints in the body. When the shoulder is frozen, the joint becomes stuck and its movement is limited.

What are the First Signs of Frozen Shoulders?

You want to treat the frozen shoulder early so that it doesn’t “freeze” completely, leaving you with little ability to move your arm. Following are early signs of the condition: 

1. Pain in your shoulder any time you try to move it

2. Stiffness that makes it difficult to move your shoulder 

3. Pain in the upper arm 

4. Unable to sleep on the side with shoulder pain

5. Difficulty sleeping

Who Gets Frozen Shoulder?

The frozen shoulder risk is increased by the following factors:

1. lack of exercise therapy after tendinitis or an injury

2. wearing a sling for more than a few days without intermittent stretching

3. rotator cuff disorders (about 10% of people with these rotator cuff disorders develop frozen shoulder)

4. enforced immobility resulting from a stroke, heart condition, or surgery

5. other conditions such as thyroid disorders or Parkinson's disease

What is Frozen Shoulder Pain Like?

The main symptoms of a frozen shoulder are pain and stiffness that make it difficult or impossible to move. You’ll likely feel a dull or achy pain in one shoulder. You might also feel the pain in the shoulder muscles that wrap around the top of your arm. You might feel the same sensation in your upper arm. Your pain may get worse at night, which can make it hard to sleep.

Where Does Frozen Shoulder Hurt the Most?

The pain is usually located over the outer shoulder area and sometimes the upper arm. The hallmark of the disorder is restricted motion or stiffness in the shoulder. The affected individual cannot move the shoulder normally. Motion is also limited when someone else attempts to move the shoulder for the patient.

Does Frozen Shoulder Go Away?

A frozen shoulder usually gets better without treatment. But it can take several months for the pain to go away completely, and a lot longer until you can move your shoulder normally again. Medication and physical therapy can help to relieve the pain and improve mobility. Surgery is only rarely considered as a treatment option because it usually has no advantages and there are various risks involved.

How Long Does it Take for Frozen Shoulder to Go Away?

A frozen shoulder has four stages, most of which lead to excruciating pain. It can last for years. Most people can see their frozen shoulder heal on its own, but it can take between 6 and 18 months, and it is very painful, in many cases preventing you from sleeping. In some cases, it never goes away. While the range of motion will gradually return, in many cases the shoulder joint will not move as it once did. In fact, according to research studies, 61% of people who do not seek treatment will have permanent damage.

What is the Fastest Way to Get Rid of a Frozen Shoulder?

Most frozen shoulders get better on their own within 12 to 18 months. For severe or persistent symptoms, other treatments include Steroid injections. Injecting corticosteroids into the shoulder joint might help decrease pain and improve shoulder mobility, especially if given soon after a frozen shoulder begins.

What Kind of Specialist Do You See for a Frozen Shoulder?

If you are experiencing pain, weakness, or any kind of injury to the shoulder, you should see a frozen shoulder specialist like an orthopedic shoulder doctor. Orthopedic sports medicine and orthopedic hand and upper extremity subspecialists are fellowship-trained orthopedists with expertise in treating conditions in the shoulder.  

Can a Chiropractor Fix a Frozen Shoulder?

Chiropractic is an effective treatment for frozen shoulder. Many patients see their general practitioner first to get a diagnosis and to make sure that there are no underlying conditions that should be treated before chiropractic is pursued. However, most chiropractors do have the capability to use X-rays and other diagnostic tools to adequately assess the patient.

A 2012 study involved reviewing the case files of 20 male and 30 female patients with frozen shoulders who underwent chiropractic treatment. All subjects sought treatment between 11 and 51 days with the median being 28 days.

Chiropractic can help reduce the pain, improve the shoulder’s range of motion, and speed recovery. The treatment depends on the symptoms that are present, how progressed the condition is, and how long the patient has had the condition.

One common chiropractic technique used to treat frozen shoulder is the Niel Asher Technique. It involves the manipulation of the joints and muscle tissues. The chiropractor applies pressure and stretches key points to help reduce pain and resolve the condition. It can make a tremendous difference in the patient’s life.

Anatomy of a Frozen Shoulder

The shoulder has a wider and more varied range of motion than any other part of the body. It pivots mainly on a ball-and-socket arrangement called the glenohumeral joint, which joins the top of the humerus (upper arm bone) to a scooped-out part of the scapula (shoulder blade) called the glenoid cavity.

The glenohumeral joint helps move the shoulder forward and backward and allows the arm to rotate and extend outward from the body. A flexible capsule filled with a lubricant called synovial fluid protects the joint and helps keep it moving smoothly. The capsule is surrounded by ligaments that connect bones to bones, tendons that fasten muscles to bones, and fluid-filled sacs called bursae that cushion tendons and bones during motion.

The band of muscles and tendons that stabilizes the shoulder and controls its movements is called the rotator cuff. This elaborate architecture of soft tissues accounts for the shoulder's marvelous flexibility but also makes it vulnerable to trauma as well as chronic wear and tear.

3 Stages of Frozen Shoulder

Healthcare providers divide frozen shoulder symptoms into three stages:

1. The “freezing” stage: In this stage, your shoulder becomes stiff and is painful to move. The pain slowly increases. It may worsen at night. The inability to move your shoulder increases. This stage lasts from six weeks to nine months.

2. The “frozen” stage: In this stage, pain may lessen, but your shoulder remains stiff. This makes it more difficult to complete daily tasks and activities. This stage lasts for two to six months.

3. The “thawing” (recovery) stage: In this stage, pain lessens, and your ability to move your shoulder slowly improves. Full or near full recovery occurs as typical strength and motion return. The stage lasts from six months to two years.

Symptoms of Frozen Shoulder

The main symptoms of a frozen shoulder are:

1. Pain

2. Decreased motion of the shoulder

3. Stiffness

A frozen shoulder can start with pain without any cause or minor trauma. The pain may be severe and prevent you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you.

Causes of Frozen Shoulder

The causes of frozen shoulder are not fully understood. There is no clear connection between arm dominance (the dominant arm is the arm you prefer to use for most tasks) and occupation. A few factors may put you more at risk for developing a frozen shoulder.

1. Diabetes. Frozen shoulder occurs much more often in people with diabetes. The reason for this is not known. In addition, diabetic patients with frozen shoulders tend to have a greater degree of stiffness that continues for a longer time before "thawing."

2. Other diseases. Some additional medical problems associated with a frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease.

3. Immobilization. A frozen shoulder can develop after a shoulder has been immobilized (held in one position without moving) for some time due to surgery, a fracture, or other injury. Having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent a frozen shoulder.

5 Frozen Shoulder Exercises

Always warm up your shoulder before performing your exercises. The best way to do that is to take a warm shower or bath for 10 to 15 minutes. You can also use a moist heating pad or a damp towel heated in the microwave, but it may not be as effective.

In performing the following exercises, stretch to the point of tension but not pain.

1. Pendulum stretch

(Perform this exercise first.)

- Relax your shoulders.

- Stand and lean over slightly, allowing your affected arm to hang down.

- Swing the arm in a small circle — about a foot in diameter.

- Perform 10 revolutions in each direction, once a day.

- As your symptoms improve, increase the diameter of your swing, but never force it.

- When you're ready for more, increase the stretch by holding a light weight (three to five pounds) in the swinging arm.

2. Towel stretch

- Grasp a three-foot-long towel with both hands behind your back, and hold it in a horizontal position.

- Use your good arm to pull the affected arm upward to stretch it.

- You can also perform an advanced version of this exercise with the towel draped over your good shoulder.

- Grasp the bottom of the towel with the affected arm and pull it toward the lower back with the unaffected arm.

- Do this stretch 10 to 20 times a day.

3. Finger walk

- Face a wall three-quarters of an arm's length away.

- Reach out and touch the wall at waist level with the fingertips of the affected arm.

- With your elbow slightly bent, slowly walk your fingers up the wall, spider-like, until you've raised your arm to shoulder level, or as far as you comfortably can. Your fingers should be doing the work, not your shoulder muscles.

- Slowly lower the arm (with the help of the good arm, if necessary) and repeat.

- Perform this exercise 10 to 20 times a day.

4. Cross-body reach

- Sit or stand.

- Use your good arm to lift your affected arm at the elbow, and bring it up and across your body, exerting gentle pressure to stretch the shoulder.

- Hold the stretch for 15 to 20 seconds.

- Do this stretch 10 to 20 times per day.

5. Armpit stretch

- Using your good arm, lift the affected arm onto a shelf about breast-high.

- Gently bend your knees, opening up the armpit.

- Deepen your knee bend slightly, gently stretching the armpit, and then straighten.

- With each knee bend, stretch a little further, but don't force it.

- Do this stretch 10 to 20 times each day.

How to Treat a Frozen Shoulder

Frozen shoulder treatment usually involves pain relief methods until the initial phase passes. You may need therapy or surgery to regain motion if it doesn’t return on its own. Some simple adhesive capsulitis treatments include:

1. Hot and cold compresses. These help reduce pain and swelling.

2. Medicines that reduce pain and swelling. These include nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen. Your healthcare provider may prescribe other painkiller/anti-inflammatory drugs. You can manage more severe pain and swelling with steroid injections. Your provider will inject a corticosteroid, like cortisone, directly into your shoulder joint.

3. Physical therapy. A physical therapist can teach you stretching and range-of-motion exercises.

4. Home exercise program. Your healthcare provider can show you exercises you can do at home.

5. Transcutaneous electrical nerve stimulation (TENS). Use of a small, battery-operated device that reduces pain by blocking nerve impulses.

If these noninvasive treatments haven’t relieved your pain and shoulder stiffness after about a year, your provider may recommend other procedures. These include:

1. Manipulation under anesthesia: During this surgery, you’ll be put to sleep and your provider will force movement of your shoulder. This will cause your joint capsule to stretch or tear to loosen the tightness. This will lead to an increase in your range of motion.

2. Shoulder arthroscopy: Your provider will cut through the tight parts of your joint capsule (capsular release). They’ll insert small, pencil-size instruments through small cuts (incisions) around your shoulder.

Providers often use these two procedures together to get better results.

How to Sleep With a Frozen Shoulder

Here are some ways to make sleeping with a frozen shoulder a little easier. 

1. Sleep with proper head and neck support. Whether you’re a back sleeper or a side sleeper, you need a pillow that keeps your head and neck in line with your spine. For side sleepers, this means a thicker pillow to lift your head. Back sleepers need a slightly lower loft, while belly sleepers need a relatively flat pillow.

2. Sleep with extra pillows. The best sleeping position for a frozen shoulder is on your unaffected side with an extra pillow between your arm. This helps open your chest and keeps your shoulders aligned. If you don’t have a body pillow, put a smaller pillow in your armpit and hug it to avoid curling your shoulders inward. A pillow between your knees can help keep your hips and spine aligned and keep you from curling inward.

3. Sleep with arms by your side. If you’re more comfortable sleeping on your back, rest your arms by your sides with your palms facing your mattress. This position puts the least amount of pressure on your shoulder joints and provides a gentle stretch to your shoulder muscles.

4. Sleep with heat. Warm compresses increase blood flow and relieve pain in your shoulder. If you want to use a heating pad on your shoulder while you sleep, be sure it has safety features such as a turn-off switch. You can also use a microwaveable buckwheat or weighted beanbag, which will gradually cool over time.

Do’s and Don’ts for Frozen Shoulder

Frozen Shoulder Do’s

If you have been diagnosed with or think you may be suffering from a frozen shoulder, here is a list of things to do:

1. Talk With Your Doctor

If the symptoms listed above sound like what you are experiencing, you should make an appointment with your healthcare provider to get a proper diagnosis. Doctors with training in orthopedics and shoulder disorders are most experienced in identifying this condition and ruling out other similar problems. To diagnose a frozen shoulder, your doctor will conduct a physical exam that includes moving the affected shoulder and seeing if the range of motion is limited or if pain occurs. They will also ask you to move the frozen shoulder yourself. Your doctor will also order imaging tests to rule out other possible causes of shoulder stiffness, typically a simple X-ray series.

2. Use mild heat

Most patients find that applying mild heat, rather than ice to the shoulder helps the symptoms. A hot tub or warm shower is a good way of doing this.

3. Be checked for other conditions that may cause a frozen shoulder

The frozen shoulder could be due to uncontrolled diabetes, smoking, or other medical problems as listed above. Your primary care doctor can easily check you for these conditions that may need treatment.

Frozen Shoulder Don’ts

If you have been diagnosed with or think you may be suffering from a frozen shoulder, do not do the following:

1. Forcing the motion

Some patients may be frustrated by the loss of motion and may want to force the shoulder to regain motion. This can be dangerous and could cause significant injury to the rotator cuff or other important parts of the shoulder joint.

2. Taking too much medication

Do not take more medication to treat this condition than is recommended on the bottle. The pain of a frozen shoulder can be intense, and over-the-counter medication may help but is often not very effective for this type of pain. Taking more than the recommended dosage could harm your stomach, your liver, your kidneys, or other organs.

How to Prevent Frozen Shoulder

It is always better to prevent adhesive capsulitis rather than try to fix it after it happens, however, that is not always the situation. In any case, there are several things you can do to keep yourself healthy and prevent further damage.

1. Maintain a strong posture

Stand tall and do not slouch as this puts stress on your shoulder joint, neck, and upper back muscles. Also, avoid lifting objects that are too heavy for you.

2. Maintain & Build Your Strength,

This will stabilize your shoulder and upper arm area, and increase the range of motion in your shoulder, arms, and back muscles. Light weights, exercise bands, and sticks are very beneficial for strengthening your upper body. Yoga, tai chi, or a daily stretching routine will help to keep your muscles and joints supple.

3. Maintain a Regular Exercise and Cross Training Program

Focus on total body fitness and include low-impact aerobic activity at least 3 days per week, such as walking, swimming, inline skating, or biking. This will help to keep you healthy overall and strengthen your body to prevent frozen shoulder or other shoulder injuries.

4. Keep Your Weight Between 18.5 and 25 on the Body Mass Index (BMI) Scale

Eat a balanced diet of protein, complex carbohydrates, fats, vitamins, minerals, phytochemicals and antioxidants. This will help you support a healthy body and will help you maintain your weight. This is especially important if you have diabetes and need to keep control of your glucose levels. Limiting your caffeine, alcohol, and nicotine consumption will also improve your health.

5. Choose Appropriate Equipment and Supports for your Body Type and Size

Shoulder supports should be used as required during activities (bracing/strapping/taping the area for extra support) but do not wear these when not participating in activities. Mobility aids (long shoe horns, front fastening bras, and/or anything that helps to prevent you from overreaching) will help alleviate your symptoms and improve your functions.

6. Avoid Doing Too Much Too Soon

Allow your body to build up its endurance, and to protect your soft tissues from injury and overuse. This is especially important when participating in a new activity. Gradually increase your participation to prevent overstraining your shoulder muscles and joints.

7. Always Warm Up Your Muscles

Warm up your muscles before exercise(especially your shoulder, arm, and back muscles) to prepare your body and raise your body temperature.

8. Always Cool Down Your Muscles

Recover from your exercise by doing a cool-down routine to lower your body temperature and relax your muscles.

9. Use proper form and techniques

Learn the correct body positions for your activity to help prevent injuries.

10. Listen to your Body

If you are suffering from shoulder pain and/or stiffness, listen to your body and decrease, modify, and/or avoid any activities or motions that cause pain and irritation such as repetitive lifting, pushing, pulling, throwing, and/or overhead movements. If you are required to perform these motions at work or play and cannot avoid them, make sure you take frequent breaks and rest to prevent fatigue and pain. It is important not to rush your recovery to prevent further damage.

How to Cure Frozen Shoulders at Home

Here are home remedies for frozen shoulder:

1. Heat Pack

Using a heat pack helps to restore enough blood circulation to the shoulder and prevents additional damage. Warm it up the shoulder by using heat packs (you can even take a hot water bath) and slowly move it in circular motions. You must ensure that the motion is moderate and gradual. Any sharp action might harm the shoulder

2. Add Epsom salt while bathing:

You may also add a little amount of Epsom salt to your water while bathing to assist with the heat supplied to your shoulders. 

3. Massage:

Gentle massage on the affected area once or twice a day with warm oil (not too hot) can prove to be beneficial in easing pain and can even help release tension in the muscles. 

4. Practice exercise daily:

2 to 3 times daily, perform mild and simple shoulder exercises. It is advised to perform a few exercises after warming up the shoulder. Exercise can improve the movement of the frozen shoulder and contribute to the physiotherapy session.

Sources:

Hopkins Medicine

Harvard Health

Cleveland Clinic

WebMD

Ortho Info

Mount Sinai

Matthew Pifer MD

Puget Sound Orthopaedics

Aid My Frozen Shoulder

NIH

Frozen Shoulder Clinic

Fix Health

Mayo Clinic

UCONN Health

Elite Orthopaedic

Gonstead Chiropractic Center