Frozen shoulder: symptoms and treatment

Frozen shoulder is a condition in which the shoulder joint capsule becomes thickened, inflamed and stiff, leading to pain and greatly reduced movement of the arm. The name comes from the feeling that the shoulder is truly frozen and cannot be moved. The condition develops gradually, through several phases, and without treatment can last for months, sometimes more than a year. With proper therapy, the range of motion and function of the arm return gradually and reliably, and the overall duration of the condition is shortened.

Symptoms of frozen shoulder

Frozen shoulder is recognized by a combination of pain and stiffness that increases through the phases of the condition. Typical symptoms are:

• shoulder pain that spreads toward the upper arm, often most pronounced at night,
• difficulty raising the arm, dressing, combing the hair and reaching behind the back,
• limited movement both actively and passively, when even the therapist can hardly move the arm,
• a feeling of stiffness and a block in the joint,
• weakening of the arm due to long disuse.

Phases of frozen shoulder

The condition typically goes through three phases. In the first, painful phase, pain dominates and increases, while movement begins to decrease. In the second, the freezing phase, pain may ease slightly, but the shoulder is at its stiffest. In the third, the thawing phase, movement gradually returns. Recognizing the phase is important because it determines how intensive the exercises are appropriate at that moment, so the therapy plan changes as the condition progresses.

Causes and risk factors

The exact cause is not always clear, but frozen shoulder occurs more often in certain circumstances. The most important risk factors are:

• longer immobility of the shoulder after an injury, fracture or surgery,
• diabetes, which significantly increases the risk and prolongs the course,
• thyroid disease,
• age between 40 and 60, somewhat more often in women,
• previous inflammation of the tendons and other shoulder structures.

How the diagnosis is made

The diagnosis is made by examination and measurement of the shoulder range of motion, where it is characteristic that movement is limited in all directions, both when the patient tries alone and when the therapist assists. Imaging is done to rule out other causes of stiffness, such as arthrosis or tendon injury. Early recognition allows therapy to shorten the overall duration of the condition.

Treatment of frozen shoulder

Treatment of frozen shoulder at the Dynamic Fizio center is aimed at reducing pain and gradually restoring movement through physical therapy tailored to the phase of the condition. Therapy includes:

• tecar therapy and electrotherapy to reduce pain and inflammation,
• manual mobilization of the joint to gradually free the stiff capsule,
• kinesitherapy with stretching and strengthening exercises to restore range of motion,
• training in exercises that the patient continues daily at home.

How treatment works at our center

The first examination is free, and at it we measure the shoulder range of motion and assess which phase the condition is in, because the therapy plan differs significantly between the painful phase and the freezing phase. In the painful phase the emphasis is on reducing pain and inflammation, and in the freezing phase on gradually restoring movement through mobilization and stretching. Therapy is done in a series and combines devices with manual techniques and kinesitherapy, and we teach you the exercises you do daily at home, since regularity is decisive.

Frequently asked questions

How long does frozen shoulder last? Without treatment it can last from several months to more than a year. Regular therapy shortens the duration and prevents lasting stiffness.

Should the exercises hurt? Exercises should be done at the edge of discomfort, but not through strong pain, because excessive stretching in the painful phase can worsen inflammation.

Why does it happen to me more than to others? People with diabetes and thyroid disease have a higher risk, as do those who kept the shoulder immobile for longer after an injury.

Can frozen shoulder recur? It rarely recurs in the same shoulder, but people who have had it, especially with diabetes, have a higher risk of it appearing in the other shoulder.

Do warm compresses help? Heat before exercises can relax the shoulder and ease movement, but on its own it does not remove the stiffness, so it is used as preparation for therapy.

How often should the exercises be done? Short exercises several times a day give a better result than one long and strenuous session, since movement returns gradually.

May I sleep on the painful shoulder? In the painful phase sleeping on that shoulder usually increases night pain, so sleeping on the other side with a pillow supporting the arm is recommended.

Will the shoulder recover on its own? Frozen shoulder often passes through all phases on its own over time, but this can take more than a year. Therapy shortens that course and reduces the risk of lasting limited movement.

May I force the movement to unfreeze it? No. Excessive and rough stretching in the painful phase increases inflammation. Movement returns gradually, in a dosed way and under supervision.

If your shoulder is stiff and painful, book a free first examination at 060/134-3303.