With frozen shoulder, reaching for a seatbelt or pulling on a coat can become a struggle. Known medically as adhesive capsulitis, it happens when the capsule around the shoulder joint becomes inflamed, then thickens and tightens. At Physical Medicine & Rehabilitation of NY & CT (PMR), frozen shoulder treatment aims to ease pain and gradually restore motion at a pace your shoulder can tolerate. Care is offered at our Danbury and Brewster, NY offices.
Not sure it’s frozen shoulder? Our shoulder pain overview covers other common causes.
Signs of frozen shoulder
- A dull, deep ache in the outer shoulder, sometimes spreading to the upper arm
- Stiffness in every direction, especially turning the arm outward and reaching behind your back
- Night pain and trouble lying on that side
- Motion that stays blocked even when someone gently moves your arm for you, a key clue to the diagnosis
The three frozen shoulder stages
- Freezing (painful) stage. Pain builds gradually and is often worse at night, while movement starts to shrink. This stage often lasts several months.
- Frozen (stiff) stage. Pain may ease, but stiffness peaks and everyday tasks get harder. This stage can also last several months.
- Thawing (recovery) stage. Motion slowly returns, over anywhere from several months to two years.
Most people regain much of their movement, though some are left with mild stiffness.
Who gets adhesive capsulitis?
The exact cause isn’t known, and often there’s no clear trigger. Risk is higher with:
- Age between about 40 and 60, and being female
- Diabetes, which also tends to make frozen shoulder more stubborn
- An overactive or underactive thyroid
- A period of keeping the arm still, such as after surgery, a fracture, a rotator cuff injury or a stroke
- Heart disease and Parkinson’s disease
When to get urgent care
A few problems can look like frozen shoulder at first but need prompt medical attention:
- Severe pain and stiffness after a fall, seizure or accident, or a shoulder that looks out of place. Go to urgent care or the ER for an X-ray to rule out a fracture or dislocation.
- A hot, red, swollen shoulder with fever or chills. Go to the ER, because a joint infection needs treatment right away.
- Shoulder or arm pain with chest discomfort, shortness of breath, sweating or nausea. Call 911.
Frozen shoulder treatment, stage by stage
Your plan follows your stage, because a painful, irritable shoulder needs gentler care than one that is stiff but calm.
Confirming the diagnosis
Your clinician compares the motion you can produce with the motion available when your arm is guided, and checks rotator cuff strength, your neck and your upper back. X-ray imaging can rule out arthritis. Overhead pain with otherwise good motion points more toward shoulder impingement.
Early on: calm the pain and protect your motion
When pain is high, aggressive stretching usually backfires. Instead, you’ll do gentle range-of-motion work within comfort, such as pendulum swings and table slides, a few minutes at a time, several times a day. Some patients also use acupuncture to help manage pain.
Stiff and thawing stages: restore movement and strength
As pain settles, frozen shoulder physical therapy becomes more active, with joint mobilization and progressive stretching to regain rotation and reach, then rotator cuff and shoulder blade strengthening. Gentle chiropractic mobilization of the upper back and neck can help the whole region move. See what physical therapy at PMR involves.
When a physician gets involved
A corticosteroid injection, given by a physician, can ease pain for some people, especially early on. If pain is severe or progress stalls, PMR coordinates with your doctor or refers you to a specialist, who may discuss procedures to release the capsule if months of care haven’t helped.
Living with a stiff shoulder
- Do your exercises little and often, not in one long, painful session.
- Warm up first with a warm shower or a heat pack.
- Stretch to mild tension, never sharp pain.
- Keep using the arm for light tasks such as eating, washing and typing.
- Rest the arm on a pillow at night to ease pressure on the joint.
Frequently asked questions
How long does frozen shoulder last?
It usually runs its course over a year or more, and full recovery can take two to three years. The painful stage and the stiff stage each tend to last several months before motion slowly returns. Frozen shoulder treatment may not shorten the natural course, but it can help you stay more comfortable and keep using your arm.
Is frozen shoulder the same as a torn rotator cuff?
No, they’re different. A rotator cuff tear mainly causes pain and weakness when lifting, but someone else can usually move your arm through a fairly normal range. Frozen shoulder causes stiffness in every direction, even when the arm is moved for you, and a cuff injury can sometimes lead to it. Learn more about a torn rotator cuff.
Will stretching make frozen shoulder worse?
The wrong dose can. Early on, forceful stretching often increases pain, so gentle movement within comfort is the goal. Once the shoulder is stiff but less painful, firmer stretching and joint mobilization are usually tolerated well. Mild soreness that settles within a few hours is a reasonable guide, and your therapist adjusts the intensity.
Get help for a stiff shoulder
Whether you’re in the painful early stage or months into stiffness, frozen shoulder treatment matched to your stage can help. Contact the PMR office nearest you:
- PMR of Danbury, CT, (203) 744-8013
- PMR of Brewster, NY, (845) 279-1135
You can also request an appointment online.