Frozen shoulder is characterised by stiffness and pain in the shoulder joint. This may seriously hamper daily functioning as it disrupts many motions, like reaching overhead to grab something from a shelf, putting on clothes, combing and so on.
Dr Raman Kant Aggarwal, Vice Chairman, Orthopaedics at Medanta, Gurugram, told HT Lifestyle about the risk factors of frozen shoulder, explaining that many pre-existing conditions create a predisposition to the ailment.
But before diving into the various risk factors, it’s important to understand what exactly frozen shoulder is and how it affects the body. Dr Aggarwal said, “Frozen shoulder, medically known as adhesive capsulitis, is a condition characterised by stiffness and pain in the shoulder joint. It significantly restricts the range of motion, making everyday tasks challenging. While the exact cause is not always clear, it involves inflammation and thickening of the connective tissue capsule that surrounds the shoulder joint, leading to scar tissue formation and a reduction in the capsule’s volume.”
The shoulder joint, particularly, is affected in the frozen shoulder condition. Explaining more about the ‘freezing process’ of this joint, he added, “The shoulder joint is a ball-and-socket joint, encased by a capsule of strong connective tissue. In the frozen shoulder, this capsule becomes inflamed, thickens, and tightens, often developing adhesions (bands of scar tissue). This process effectively ‘freezes’ the joint, limiting its movement.”
Who has higher risk of getting frozen shoulder?
Dr Aggarwal pointed out that frozen shoulder can happen to anyone, but the chances are higher in people between 40 and 60 years of age. He further alerted that it affects women more than men.
He listed out the health conditions that increase risk:
- Diabetes: Individuals with diabetes are at a significantly higher risk, with up to 20% of diabetic patients experiencing frozen shoulders.
- Thyroid disorders: Both an overactive (hyperthyroidism) and an underactive (hypothyroidism) thyroid can increase susceptibility.
- Cardiovascular disease: Some studies suggest a link between heart conditions and frozen shoulders.
- Parkinson’s disease: This neurological disorder can also be a risk factor.
- Stroke: Patients recovering from a stroke, especially if it affects the arm, may develop frozen shoulders due to immobility.
Beyond these health conditions, immobility also plays a role in the development of frozen shoulder. So when the shoulder remains immobile after surgery or injury, the risk of developing this painful stiffness heightens.
The doctor shared, “If the shoulder is immobilized for a prolonged period due to injury, surgery (such as a mastectomy or rotator cuff repair), or even a broken arm, the risk of developing a frozen shoulder increases. This highlights the importance of early, gentle movement when medically appropriate after an injury or surgery.”
Three stages of frozen shoulder
Frozen shoulder has a timeline, so it doesn’t happen overnight. It gradually develops over three distinct stages. Dr Aggarwal listed out these stages:
- Freezing stage: This initial phase is marked by increasing pain and a gradual loss of shoulder motion. Pain often worsens at night. This stage can last from 6 weeks to 9 months.
- Frozen stage: Pain may begin to decrease during this phase, but the stiffness remains severe. Moving the shoulder becomes very difficult, and the range of motion is significantly limited. This stage can persist for 4 to 12 months.
- Thawing stage: During this recovery phase, the shoulder’s range of motion slowly begins to improve. This process can be gradual and may take anywhere from 6 months to 2 years, or even longer, for full or near-full recovery.
Diagnosis and treatment
For diagnosis, Dr Aggarwal shared that a physical exam is done to check the shoulder’s range of motion and to rule out other possible issues. He also added, “Imaging tests like X-rays or MRI may be used to exclude other problems such as arthritis or rotator cuff tears.”
Next, regarding treatment, he revealed that the treatment is mainly aimed towards reducing pain and helping you move your shoulder again. This also includes pain relievers, anti-inflammatory medications, and physical therapy.
Other than this, the treatment also includes physical therapy, gentle exercises to stretch the shoulder and improve flexibility. Dr Aggarwal noted that in persistent cases, surgery is done to loosen the tight shoulder.