Causes of frozen shoulder include inflammation; immobilization; or various medical conditions, such as diabetes. The problem also appears to more often affect patients between the ages of 40 and 60 years old. Symptoms of the condition often develop slowly and occur in three stages: painful, frozen and thawing. Doctors evaluate the shoulder and use imaging tests to diagnose a frozen shoulder. Treatment usually involves physical therapy and anti-inflammatory medications.
The shoulder joint consists of ligaments, tendons, and bones enclosed in what is known as the joint capsule. Frozen shoulder occurs when the capsule thickens and becomes inflamed, leading to pain and stiffness. Sometimes, causes of frozen shoulder are unknown, but they often are associated with immobilization after shoulder surgery or open heart surgery. Inflammation from frozen shoulder, also known as adhesive capsulitis, seems to appear often in people with medical conditions such as diabetes, Parkinson's disease, hyperthyroidism or hypothyroidism as well. Researchers believe there is an autoimmune link to frozen shoulder, though it has not yet been identified.
Besides pain and stiffness, symptoms of frozen shoulder also include decreased mobility. Symptoms typically occur in three stages that last over a period ranging from six weeks to 26 months, and they include painful, frozen and thawing. In the painful, or "freezing" stage, pain occurs in the shoulder joint and increases during movement. During the "frozen" stage, the shoulder stiffens, making it harder for the person to reach above his head. Range of motion in the shoulder slowly returns to normal during the final "thawing" stage.
A doctor diagnoses frozen shoulder pain by conducting an evaluation of the symptoms. Causes of frozen shoulder can also be detected through a physical exam. An MRI and X-rays often are used as well to help detect frozen shoulder causes and to rule out other possible problems, such as a rotator cuff or sports injury.
Frozen shoulder pain usually resolves on its own, but it may take a few years if the patient goes without any treatment. Treatment for frozen shoulder includes corticosteroids and nonsteroidal anti-inflammatory drugs to relieve pain and inflammation. Physical therapy also can help maintain mobility in the shoulder.
Surgery or other procedures may be required if the painful condition is not resolved through medications or physical therapy. In this case, the doctor may try a procedure called distension, which involves stretching the shoulder joint tissue by injecting sterile water into the area. The injection helps the shoulder move more easily. With shoulder manipulation, the doctor loosens the tissue by moving the shoulder joint while the patient is under general anesthesia. Another option, arthroscopic surgery, is designed to remove adhesions or damaged tissue that contributed to causes of frozen shoulder.