What are the other Names for this Condition? (Also known as/Synonyms)

• Adhesive Capsulitis
• Adhesive Capsulitis of the Shoulder
• Pericapsulitis of Shoulder

What is Frozen Shoulder? (Definition/Background Information)

• Frozen Shoulder is a painful condition that is characterized by pain and stiffness in the shoulder. Over time, due to this condition, there is a decreased range of motion of the shoulder
• It is caused by excessive inflammation and buildup of scar tissue within the shoulder. Overall, women have a higher incidence rate of Frozen Shoulder, than men
• The treatment measures for Frozen Shoulder include both nonsurgical and surgical methods
• Individuals, who develop this painful condition may require several months of rehabilitation, in order to make a full recovery

Who gets Frozen Shoulder? (Age and Sex Distribution)

• Frozen Shoulder may occur in individuals of all ages, races, ethnic groups, and gender
• A high percentage of individuals, who develop the condition are between the ages of 40 and 60 years. However, women seem to have a higher rate of incidence

What are the Risk Factors for Frozen Shoulder? (Predisposing Factors)

Common risk factors associated with a Frozen Shoulder include:

• Individuals between the age of 40 and 60 years, have an increased risk of developing a Frozen Shoulder
• Women are more likely to develop this shoulder condition, than men
• Prolonged immobilization of the shoulder due to injuries, such as caused by a broken arm, a cerebrovascular stroke, or a direct injury to the shoulder joint (like rotator cuff injury)
• Hypothyroidism: A medical condition characterized by the body’s inability to produce sufficient thyroid hormone
• Hyperthyroidism: A medical condition arising from an overactive thyroid gland
• Parkinson's disease: A progressive disorder of the nervous system that affects mobility
• High blood glucose levels that result either from an insulin secretion deficiency (diabetes type I), or an insulin resistance in the body (diabetes type II)
• Cardiovascular disease and increased cholesterol levels
• Infections, such as tuberculosis, are also known to increase the risk. Although, the cause for such an increased risk, is unknown

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Frozen Shoulder? (Etiology)

The direct cause for the development of a Frozen Shoulder is unknown. However, physicians believe that this condition is likely to occur in individuals, who have certain risk factors, such as:

• Prolonged immobilization of the shoulder due to injuries, such as a broken arm, a cerebrovascular stroke, or due to any direct injury to the shoulder joint (like rotator cuff injury)
• Medical conditions related to the thyroid gland, such as hypothyroidism and hyperthyroidism
• Parkinson's disease: A progressive disorder of the nervous system that affects mobility
• High blood glucose levels due to diabetes type I, or diabetes type II
• Cardiovascular disease and increased cholesterol levels
• Infections, such as tuberculosis

What are the Signs and Symptoms of Frozen Shoulder?

Frozen Shoulder usually develops very slowly over time and is characterized by 3 stages. Each of these stages may last several months.

• Painful stage: Pain and minimal range of motion occur with shoulder movement
• Frozen stage: During this stage, the pain may improve; however, it may still be difficult to perform ones’ daily activities due to a limited range of motion of the shoulder
• Thawing stage: In this stage, the range of motion slowly starts to improve. However, a complete return to normal strength and full motion range, usually takes between 6 months to 2 years

How is Frozen Shoulder Diagnosed?

Diagnostic methods that a physician may use to help diagnose a Frozen Shoulder include:

• Physical examination: A thorough physical examination can usually aid in diagnosing a Frozen Shoulder. The physician may ask the individual to perform simple physical tasks, such as moving their shoulder in all directions, raising hands over their heads, and touching the opposite shoulder by reaching across the chest. This will help the physician determine the extent of shoulder movement, if it is restricted, and if any pain exists. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
• X-rays of the shoulder: X-rays use radiation to produce images of the shoulder. It can help the physician rule out other possible causes for shoulder discomfort, such as arthritis
• Magnetic resonance imaging (MRI) of the shoulder: An MRI is a more detailed scan that uses radio waves and a magnetic field to produce clearer images of the bones and soft tissue that surrounds the shoulder. It allows a physician to view any damage to the shoulder

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the Possible Complications of Frozen Shoulder?

A common complication associated with Frozen Shoulder is prolonged pain and stiffness, of the affected shoulder. This can result in permanent loss of shoulder joint range of motion.

How is Frozen Shoulder Treated?

The treatment of Frozen Shoulder includes both nonsurgical and surgical methods.

Nonsurgical treatment methods include:

• Application of a hot/cold pack to the shoulder
• Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen, may be used to help decrease the pain and swelling
• Individuals are likely to need physical therapy exercises. The goals of these exercises are to strengthen the shoulder, improve flexibility, and decrease stiffness. It may take several months for an individual to complete the physical therapy program and regain full strength and functionality
• Corticosteroid injections help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections, may injure the joints in the long-run
• Joint distension by injecting sterilized water into the shoulder joint. This helps in releasing the adhesions between the tissues and in increasing the range of motion. This procedure is also termed as hydrodilatation therapy

Surgical treatment methods include:

• Manipulation under anesthesia: During this procedure, a physician forces the shoulder to move, causing the capsule and scar tissue to stretch or tear
• Shoulder arthroscopy: Arthroscopic surgery is a minimally invasive surgical procedure that is used to visualize, diagnose, and repair the shoulder joint, using small medical instruments. These instruments are inserted through a small incision within the shoulder

How can Frozen Shoulder be Prevented?

Prolonged immobilization of the shoulder caused by injuries is among the main causes of Frozen Shoulder. Additional recommendations to help prevent the condition include:

• Undertake a proper treatment of type I diabetes and type II diabetes
• In individuals with hypothyroidism or hyperthyroidism, prompt treatment of the thyroidal condition, will help prevent the development of a Frozen Shoulder
• Prompt and adequate treatment of individuals with Parkinson's disease and cardiovascular disease
• A physician may discuss certain exercises that can help individuals maintain their range of motion in the shoulder, while not aggravating the condition

What is the Prognosis of Frozen Shoulder? (Outcomes/Resolutions)

• The long-term prognosis of a Frozen Shoulder is usually good, in a majority of individuals
• Some individuals may regain any lost motion within their shoulder, by using simple non-surgical treatment measures. The prognosis in such individuals is good
• However, it is important to consult a qualified healthcare provider, before using any self-remedy measures; since, this may aggravate the condition in a significant manner

Additional Relevant Information for Frozen Shoulder:

An arthroscopic procedure involves the visual examination of a bone joint (such as a shoulder joint or knee joint) with a camera, which will not only help in the diagnosis, but also in the treatment of certain joint conditions. The following article link will help you understand the arthroscopic surgical procedure.

https://www.dovemed.com/common-procedures/procedures-surgical/arthroscopy/