What Is a Frozen Shoulder?

A frozen shoulder, also known as adhesive capsulitis, is a condition involving pain and stiffness in the ball-and-socket joint of the shoulder (the glenohumoral joint). It usually develops over time and can limit the functional use of your arm. The shoulder pain and tightness of a frozen shoulder can make it difficult to reach overhead.

People with diabetes, thyroid disease, and cardiac conditions are especially likely to develop frozen shoulder, and women develop it more often than men. Frozen shoulder is most common in people over 40.

This article explains the symptoms and causes of frozen shoulder. It also describes how the disorder is diagnosed and treated.

Symptoms and Stages

Symptoms of frozen shoulder include:

• Dull or aching pain throughout the shoulder that may radiate into the upper arm
• Limited range of motion in the main shoulder joint
• Pain that's triggered by even the smallest movements
  

These symptoms can make it hard for you to perform simple activities, like putting away dishes or combing your hair. You may have difficulty reaching behind your back to grab something from your back pocket. Putting on a belt may be painful, too.

The symptoms of frozen shoulder aren't due to weakness, but to actual rigidity in the joint. You will not be able to raise your arm. And if someone else tries, they won't be able to lift it, either. Often, frozen shoulder goes away on its own, without treatment. The typical progression is marked by three stages:

• Freezing stage: When the pain and restricted motion begin
• Frozen stage: When motion is severely limited
• Thawing stage: When the shoulder starts to loosen up

It can take years to get to the thawing stage, so you're better off seeking treatment rather than just waiting for it to get better.

Causes

The cause of frozen shoulder isn't yet understood, but the condition is often tied to a systemic condition, or one that affects the entire body. Such a condition might include:

• Adrenal disease
• Diabetes
• Heart and lung disease
• High cholesterol
• Thyroid disease

Frozen shoulder is also associated with damage to the joint from injuries or other shoulder problems, such as:

• Calcific tendinitis
• Dislocation
• Fracture
• Muscle or connective tissue injury
• Osteoarthritis
• Rotator cuff tendinopathy
  

Frozen shoulder related to any of these causes is considered secondary. In some cases, it can occur without there being any illness or injury. It is considered primary or idiopathic frozen shoulder.

Diagnosis

You can get a pretty good idea of whether you have frozen shoulder with a simple self-test. Just remember that it's no substitute for a diagnosis from your healthcare provider:

Self-Test

Stand in front of a mirror or have someone watch you as you:

1. Slowly raise both arms up in front of you and overhead. If you have a frozen shoulder, the arm may stop just slightly above parallel with the floor, your shoulder and shoulder blade will rise toward your ear unnaturally, and the motion may cause pain in the shoulder joint. Slowly lower your arms.
2. Slowly lift your arm out to the side. If your shoulder goes up to where it's level with the floor, and it's painful, you may have a frozen shoulder. Your shoulder may also move up towards your ear like in the previous motion test.
3. Stand with both arms at your sides and bend your elbows to 90 degrees. While keeping your elbows tucked in at your sides, rotate your arms outward. This direction of motion is called external rotation. If you have a frozen shoulder, the painful side will not rotate out as far as your pain-free arm.
   

At the Provider's Office

If the self-test indicates a frozen shoulder, make an appointment with your healthcare provider or physical therapist. There are no special tests for diagnosing a frozen shoulder, and it doesn't show up on an X-ray or magnetic resonance imaging (MRI) test. However, these kinds of imaging tests may be ordered to rule out other possible causes.

A frozen shoulder diagnosis is generally made by observing the range of motion in your shoulder, considering the two types of range of motion:

• Active range of motion is how far you can move a body part on your own.
• Passive range of motion is how far someone else can move the body part for you.

Many causes of shoulder pain involve limits in only active range of motion. With a frozen shoulder, it's passively limited as well. By getting a diagnosis and treatment during the freezing stage, you may be able to keep the condition from progressing and shorten the time you must deal with pain and functional limitations.

Treatment

Physical therapy for a frozen shoulder usually involves exercises to help reduce pain and possibly to improve your shoulder's range of motion. Your physical therapist can teach you what to do and what to avoid.

Typically, strength is not affected when you have a frozen shoulder, but your physical therapist may work with you to help improve the functional mobility of your arm. Anti-inflammatory medications and corticosteroid injections may help relieve your pain. So can applying an ice pack for 15 minutes at a time. Surgery for a frozen shoulder is rarely required, but it's an option in some severe cases.

Summary

Frozen shoulder involves pain and stiffness in the ball-and-socket joint of the shoulder. It usually develops over time and can limit the functional use of your arm. The symptoms include a limited range of motion in the main shoulder joint, pain that's triggered by even the smallest movements, and pain throughout the shoulder that may be dull or aching and may radiate into your upper arm. The cause of frozen shoulder isn't quite understood, but it may linked to a systemic illnesses, or those that affect the entire body. Physical therapy for a frozen shoulder usually involves exercises to help reduce pain and the shoulder's range of motion.

A Word From Verywell

Recovering from frozen shoulder often requires the services of a physical therapist. If you don't know one, ask a trusted friend or family member for a referral. It's important to work with a therapist you like and who makes communication easy. Sutter Health also recommends finding a therapist who works close to your home or workplace. Proximity will make it easier for you to show up for all of your appointments and keep your recovery plan on track.