Frozen Shoulder

The majority of frozen shoulder cases are what are called ‘idiopathic,’ meaning we don’t know exactly what causes it to happen. However, there are certain conditions that increase your chances of developing frozen shoulder including diabetes, thyroid conditions, rheumatoid arthritis, or certain lung and heart conditions.

When there is a known cause, it is called ‘secondary’ frozen shoulder, meaning that it occurred as the result of something else. The most common causes of secondary frozen shoulder are traumatic injuries to the shoulder or recent shoulder surgery leading to the development of excessive scar tissue.

Frozen shoulder is a relatively common condition, typically affecting patients between the ages of 40 and 70 years old, and occurs more commonly in women than in men.

The primary symptom of frozen shoulder is severely limited range of motion. It can often progress to the point that simple movements of daily activities are either impossible or incredibly painful. The pain is typically described as dull or achy; however, it can be sharp if the patient bumps the affected arm or moves too quickly. The condition typically progresses through stages, with pain and stiffness intensifying over time.

The diagnosis of frozen shoulder is largely based on patient symptoms and physical exam. One of the characteristics of frozen shoulder that is different from other painful conditions of the shoulder is the limited passive range of motion. In other words, patients suffering from frozen shoulder experience significant shoulder stiffness even when Dr. Chahla attempts to move the shoulder. This is because the tight scar tissue that surrounds the shoulder is physically restricting the motion of the joint. In addition to the physical exam, Dr. Chahla and his team will also ask you questions about your past medical history, past surgical history to the shoulder, and recent injuries that may point to a cause of secondary frozen shoulder. If needed, a variety of imaging techniques can be used to help make the diagnosis. These tests include MRI and ultrasound, which both allow Dr. Chahla to see the tissue surrounding the shoulder joint to help make the diagnosis.

Frozen shoulder typically progresses through three stages. These stages describe the natural course of the condition and its associated symptoms. It’s important to note that not all individuals with frozen shoulder progress through these stages at the same rate, and the duration and severity of each stage can vary from person to person.

Freezing Stage (Painful Stage):

This initial stage can last from 6 weeks to 9 months. It is characterized by a gradual onset of shoulder pain, which tends to worsen over time. During this stage, there is increasing stiffness and a noticeable loss of range of motion in the affected shoulder. Pain is typically the most prominent symptom, particularly at night, and it can be quite severe.

Frozen Stage (Adhesive Stage):

The frozen stage can last from 4 to 12 months or longer. While the pain may decrease during this stage, the shoulder’s stiffness and restricted mobility become more pronounced. It becomes challenging to perform everyday activities due to the limited range of motion. Shoulder muscles may begin to atrophy (shrink) due to underuse. 

Thawing Stage (Recovery Stage):

This final stage can last from 6 months to 2 years. In the thawing stage, the shoulder’s range of motion gradually improves, and pain subsides. Patients often experience a return to normal or near-normal shoulder function, although it may not fully recover in some cases. Physical therapy, exercises, and stretching are crucial during this stage to expedite recovery and prevent relapse.