FROZEN SHOULDER

A condition characterized by stiffness and pain within the shoulder.

The condition occurs more commonly in people with diabetes and in people who've kept their arm immobilized for an extended period of your time.

Symptoms

Frozen shoulder typically develops slowly, and in three stages. Each stage can last for of months.

 

Freezing stage. Any movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited.

Frozen stage. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes tougher.

Thawing stage. The range of motion in your shoulder begins to improve.

For some people, the pain worsens at midnight, sometimes disrupting sleep.

 

Causes

The bones, ligaments and tendons that compose your shoulder are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens round the shoulder, restricting its movement.

 

Doctors aren't sure why this happens to some people, although it's more likely to occur in people that have diabetes or those that recently had to immobilize their shoulder for an extended period, like after surgery or an arm fracture.

 

How does a frozen shoulder happen?

The process usually begins with an injury (such as a fracture) or inflammation of the soft tissues, typically because of overuse injuries like bursitis or tendinitis of the rotator cuff. Inflammation causes pain that's worse with movement and limits the shoulder's range of motion.

 

When the shoulder becomes immobilized during this way, the connective tissue surrounding the glenohumeral joint — the joint capsule — thickens and contracts, losing its normal capacity to stretch. Trying to avoid the pain caused by moving the shoulder results in further contraction of the capsule. The humerus has less space to maneuver in, and therefore the joint may lose its lubricating synovial fluid. In advanced cases, bands of connective tissue (adhesions) form between the joint capsule and therefore the head of the humerus.

 

A frozen shoulder may take two to nine months to develop. Although the pain may slowly improve, stiffness continues, and range of motion remains limited.

 

How do health care professionals diagnose a frozen shoulder?

A frozen shoulder diagnosed during examination when the shoulder range of motion is significantly limited, with either the patient or the examiner attempting the movement. Underlying diseases involving the shoulder will be diagnosed with the history, examination, blood testing, and X-ray examination of the shoulder.

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