In Japan they call it 50 year old shoulder, an inexplicable pain that grows in the shoulder, making it harder and harder to move. It is most common in people over 45 and the stiffness that results is so severe, in America we call the ailment frozen shoulder.
As mysteriously as it begins, it also has a tendency to go away on its own – the problem is that the process can take up to three years, and it comes with a whole lot of pain and suffering along the way. That is, unless you get treatment.
Frozen shoulder, also called adhesive capsulitis, affects up to five percent of the population and tends to occur in women more than men. According to The American Academy of Orthopaedic Surgeons, the condition often has no known cause. The tissue surrounding the shoulder joint, called the capsule, thickens, becoming increasingly stiff and inflamed. Scar tissue adhesions form and often there is less fluid in the joint.
These changes can be extremely painful and severely limit mobility of the shoulder. A frozen shoulder often results in loss of work, inability to play sports, and decreased quality of life. It typically progresses through three stages lasting 18 months on average but as long as 3 years.
The lifecycle of a frozen shoulder
Stage One – Freezing
This is the most painful phase. A gradual increase in pain occurs, usually felt on the outside of the shoulder and sometimes in the upper arm. The pain is worse with movement. This leads patients to progressively use their arm less and less.
Stage Two – Frozen
Because of the changes to the capsule and the loss of use of the arm, the shoulder becomes extremely stiff. While this phase is less painful, the limitations of motion can be severe at this stage. Patients often report they are unable to raise their arm to accomplish simple tasks like brushing their teeth, washing their hair, or removing their shirt.
Stage Three – Thawing
During this phase, pain begins to decrease, and range of motion begins to increase. Eventually, strength and use of the arm returns to normal, or near-normal. This phase alone can take up to two years.
The good news is that the time and suffering involved with this condition can be significantly reduced with treatment. Most of the time, treatment involves a combination of medication and physical therapy. In some cases, surgery is the best solution.
Physical therapy will vary somewhat depending on which stage you are in (freezing, frozen, or thawing) but it includes exercise and stretching. Some of this you will do on your own at therapy and as a home exercise program. According to the American Physical Therapy Association, your therapist will use special techniques to gently mobilize the joint and stretch the arm to help increase motion and decrease pain.
While oral medication is often used, your physician may also perform injections into the shoulder to reduce pain and inflammation. Surgery is almost never the first line of treatment but it can be extremely effective. An orthopedic surgeon has several options here. He or she may simply stretch the arm back to full motion under anesthesia, something that would be intolerable otherwise. This is sometimes done in combination with arthroscopic (minimally invasive) surgery.
Whichever option turns out to be best for you, the sooner you get treatment, the better. Months and even years can be cut out of your recovery time depending on how soon you receive treatment. Further, the time you do spend dealing with this condition will be far less painful and limiting if you get treatment.
The bottom line: If you find yourself of a certain age and experiencing shoulder pain, don’t wait to get it checked out. Call our office today and make an appointment to see one of our physicians, it’ll be well worth your time.