Do you struggle to reach items off a high shelf or have trouble putting your arm in your sweater? Are you experiencing pain or a reduced range of motion? Have your symptoms gotten worse over time instead of better? If so, you may be suffering from frozen shoulder. Fortunately, Dr. Mufaddal Gombera can help.
At Fix My Shoulder, his practice that is part of the Fondren Orthopedic Group, in Houston, Texas, Dr. Gombera and his team specialize in shoulder-specific conditions using the most advanced treatments available. As a board-certified, fellowship-trained orthopedic surgeon, he also practices sports medicine, performs arthroscopy, and treats injuries to the hip and knee.
Frozen shoulder symptoms and stages
Also known as adhesive capsulitis, frozen shoulder results when the joint becomes stiff over a period of time. This occurs when the shoulder capsule, the strong connective tissue surrounding the joint, thickens and tightens. Adhesions — thick bands of tissue — form and often there is less synovial fluid to lubricate the capsule and joint.
Typically there are three stages. The first segment, known as "freezing," can last from six weeks to nine months and involves an increasing amount of pain and decreasing range of motion. During the four-to-six month "frozen" stage, pain may decrease but stiffness continues and can make daily activities a challenge. Eventually the shoulder reaches the "thawing" period where range of motion improves and movement and strength return to normal or close to it. This stage can last from six months to two years.
Doctors don't completely understand what causes frozen shoulder but there are certain risk factors, including being between the ages of 40 and 60 and being female. Having certain medical issues like diabetes, hypothyroidism, hyperthyroidism, heart disease, tuberculosis, and Parkinson's disease can also make frozen shoulder more likely.
It can also result when the shoulder has been immobilized for a period of time, like with an injury, stroke, or during recovery from surgery. In cases like this, it's important to discuss with a doctor possible exercises that can be done to maintain the range of motion and prevent frozen shoulder from developing.
Diagnosing frozen shoulder
Often, frozen shoulder can be diagnosed through a physical exam. Typically, a doctor tests active range of motion by having the patient move in certain ways. Passive range of motion is also evaluated by the doctor manipulating the arm while the muscles are relaxed. Pain levels and range of motion are determined during both assessments.
In some cases, imaging tests like X-rays, an MRI, or an ultrasound may be used to rule out other causes and/or identify any problems that could be contributing to the issue.
Treatment for frozen shoulder
In most cases, frozen shoulder eventually heals on its own without surgery. Physical therapy can help with range of motion, and over-the-counter pain medications like ibuprofen can assist in reducing pain and inflammation. For stubborn cases, steroid injections and/or shoulder manipulation can help as well. Only rarely is arthroscopic surgery to remove scar tissue conducted.