DEFINITION--Pain and stiffness in the shoulder joint that progresses to
inability to use the shoulder. In this case, "frozen" does not relate to
BODY PARTS INVOLVED--Shoulder tendons, bursa, joint capsule, muscles, blood
vessels and nerves.
SEX OR AGE MOST AFFECTED--All ages, but most common in athletic adolescents and
SIGNS & SYMPTOMS
- Pain in the shoulder, often slight, that progresses to severe pain that interferes with
sleep and normal activities. Pain worsens with shoulder movement.
- Stiffness in the shoulder that prevents normal movement. Reduced movement increases
- Pain in the arm or neck.
- Inability to move the shoulder.
- Intolerable shoulder pain.
CAUSES--Minor shoulder injury or inflammation, such as bursitis or tendinitis,
that worsens from lack of use. Adhesions (constricting bands of tissue) form with disuse
in 7 to 10 days. Adhesions increase disuse. After 3 weeks of disuse, adhesions grow so
severe that the joint cannot move.
RISK INCREASES WITH
- Neglect of minor injuries, including bursitis or tendinitis.
- Poor physical conditioning and occasional athletic activity.
- Diabetes mellitus.
- Peripheral vascular disease.
- Sedentary workers.
HOW TO PREVENT
- Obtain medical treatment for bursitis and tendinitis, including exercises to prevent
formation of adhesions.
- Do regular stretching exercises.
What To Expect
- Your own observation of symptoms.
- Medical history and physical exam by a doctor.
- X-rays of the shoulder (arthrography) or MRI (See Glossary)
of the shoulder.
APPROPRIATE HEALTH CARE
- Self-care after diagnosis.
- Doctor's treatment, including manipulation of the shoulder to break up adhesions. This
is done in a hospital or outpatient surgical facility under general anesthesia.
- Physical therapy and exercises.
- Surgery may be necessary in severe cases to remove adhesions or repair the capsule.
- Permanent shoulder disability and pain without treatment or with delayed treatment.
- Tearing of the shoulder capsule due to weakness and scar tissue.
PROBABLE OUTCOME--Usually curable with treatment and rehabilitation (but may
take several months). Some heal spontaneously.
How To Treat
- Wearing a sling may help ease discomfort.
- Application of heat (warm compresses or heating pad) to the affected area helps relieve
pain. For some patients, ice may be more helpful.
- Your doctor may prescribe: Nonsteroidal anti-inflammatory drugs. Injections of cortisone
and local anesthesia into joints to reduce pain and inflammation.
- For minor pain, you may use non-prescription drugs such as aspirin.
- Physical therapy and passive shoulder exercises.
- Resume your normal activities as soon as symptoms improve.
DIET--No special diet. Vitamins and mineral supplements don't help unless you
can't eat a normal, well-balanced diet.
Call Your Doctor If
- You have symptoms of a frozen shoulder.
- You have persistent shoulder pain, indicating possible bursitis or tendinitis.
- New, unexplained symptoms develop. Drugs used in treatment may produce side effects.