Frozen shoulder feels very much like the name suggests. While it may not be cold it certainly does not want to move the way a shoulder is supposed to. If you try it can create immense pain. So you tend not to try which means the shoulder muscles become more tight resulting in greater restriction and lack of movement. This if left untreated can become a chronic condition.
What is Frozen Shoulder?
Frozen shoulder is the common name for adhesive capsulitis, which is a shoulder condition that results in pain and a restriction on range of motion. The muscles and tissues in your shoulder joint over time can become thicker and tighter leading to damage and scar tissue forming., As a result, your shoulder joint becomes restricted and painful.
What are the symptoms?
Frozen shoulder generally develops over three stages which can take some time or they can escalate rapidly in the case of a specific injury to the tissues.
- Freezing – This is where the pain normally begins. When we feel pain we naturally avoid the pain and reduce the range in which we move a joint to avoid that pain. Excess swelling can also result in the range of movement being reduced.
- Frozen – In some cases during this stage the pain may, but not always, reduce. However the shoulder joint becomes much more stiff and difficult to move.
- Thaw – This stage is where the swelling begins to reduce leaving more room for the tendons and shoulder tissue to be able to move and the range of motion begins to improve.
Quite often pain can become quite severe during the night affecting sleep. As you can imagine a lot of pain and poor sleep can lead to significant impacts on your mood, energy levels and stress.
What are the causes?
The bones, ligaments and tendons that make up your shoulder joint are encapsulated in connective tissue. When thickening of this capsule occurs it creates more friction and pressure leading to damage of the tendons, muscles and tissues and reduces the ability of the shoulder to move properly and tightens around the shoulder joint, restricting its movement.
It is sometimes not clear why this swelling occurs but can be linked to excessive use and hyperextension of the shoulder, specific impact injury or tearing of the muscles and tendons that operate through the shoulder joint.
Frozen shoulder also seems to be more prevalent in:
- People suffering from stroke recovery
- People aged between 40 and 60 years of age
- Injury recovery that restricts the movement of the shoulder
- People suffering from thyroid disease, Diabetes, Parkinson’s disease and heart disease
How is Frozen Shoulder diagnosed?
- Physical examination including range of motion tests and assessing the location of pain
- MRI, ultrasound or X-ray
How is Frozen shoulder treated conventionally?
There are two main approaches to treating this condition. The most important is reducing the pain. The problem with pain it creates tension to protect the injury and is as previously mentioned it leads us to immobilise the area that is painful. As a result the muscles become more and more tight exacerbating the underlying problem. The second goal is to improve the range of motion to loosen the associated muscles and break up any scar tissue or adhesions.
Increasing motion – This needs to be done carefully and with professional guidance. If the shoulder is moved too much too quickly more pain and inflammation resulting in greater protection and reduced movement. In most cases you will be given gentle exercises to help gradually loosen up the shoulder joint without aggravating it. It is important in this stage not to take the shoulder to the point of pain.
Decreasing pain – traditionally this is achieved with the use of anti-inflammatories. Pain relievers and in some cases steroid injections directly into the joint. There are some risks associated with traditional pain management strategies which you can read more about here.
Surgery is usually considered as the last option and may be necessary in the case of significant muscle or tendon damage.
What are some other ways to help?
Massage can help to loosen the tight muscles improving movement and reducing pain. It is very important that the practitioner does not use too much pressure as this can again exacerbate the problem.
Stretching can also help loosen the shoulder muscles but generally should be done under professional advice.
Acupuncture has been found in numerous research trials to have a strong impact and improved range of motion. In a systematic review (1) of 478 clinical trials using acupuncture found to have a positive affect in pain reduction and improved shoulder mobility. Another clinical trial (2) found acupuncture to have immediate and long lasting effects in the reduction of pain.
To find out more about pain management check out our detailed review of conventional and no conventional methods here.
Jeff Shearer has been in practice since 1995 and
loves sharing his knowledge on better ways to live.
- The Effectiveness of Acupuncture in the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis, September 2020, Eyal Ben-Arie, Pei-Yu Kao, Wen-Chao Ho, Yu-Chen Lee, Evidence-based Complementary and Alternative Medicine2020(3):1-14
- Immediate Pain Relief in Adhesive Capsulitis by Acupuncture—A Randomized Controlled Double-Blinded Study Sven Schröder, MD, Dr. med. (PhD), Gesa Meyer-Hamme, MD, Thomas Friedemann, PhD, Sebastian Kirch, cand. med., Michael Hauck, MD, Dr. med. (PhD), Rosemarie Plaetke, PhD, Sunja Friedrichs, cand. med., Amit Gulati, PhD, Daniel Briem, MD, Dr. med. (PhD), Pain Medicine, Volume 18, Issue 11, November 2017