man holding left shoulder September 2, 2021

What are the First Signs of Frozen Shoulder Syndrome?

Frozen shoulder syndrome, known as adhesive capsulitis in the medical community, is a slow-developing medical condition that causes a painful restriction in the shoulder’s range of motion. This restriction is caused by soft tissue adhesions and inflammation that create a mechanical obstruction in the shoulder capsule. 

Frozen shoulder syndrome makes daily activities, such as washing your hair, reaching for a high shelf, or even sleeping, into painful and arduous tasks. What’s worse, many people compensate by relying on their other arm, which can lead to imbalances in the opposite shoulder and other parts of the body, compounding the problem. 

Frozen shoulder syndrome is poorly understood by many health practitioners, so identifying early frozen shoulder symptoms can help people avoid a misdiagnosis and seek the right course of treatment. 

What Causes Frozen Shoulder?

person holding shoulder blade

The reason why certain people develop frozen shoulder is not fully understood by the medical community. However, while the underlying causes are not always clear, it is well known that there are certain risk factors that make people more likely to develop adhesive capsulitis. 

For example, women are roughly twice as likely to develop frozen shoulder as men. And although frozen shoulder most often occurs in people who are between the ages of 40 and 60, it can affect people at any stage of their adult lives. 

Also, people with certain medical conditions, such as diabetes, Parkinson’s disease or hormonal imbalances, face an increased risk of developing frozen shoulder. Finally, shoulder injuries, nerve compression in the shoulder area, prolonged immobility of the shoulder, and any shoulder injuries that requires surgery increase the likelihood of frozen shoulder. 

How Adhesive Capsulitis Affects the Shoulder Joint

model of the shoulder joint capsule

As a ball-and-socket joint, the shoulder is responsible for any arm motion that involves lifting, pushing or pulling. When someone develops frozen shoulder, it is because the shoulder joint capsule (the intersection of the upper arm, shoulder blade and collarbone) is physically restricted. 

These restrictions in shoulder movement result from the formation of adhesions, which are essentially small bits of scar tissue, and the inflammation of the bursae in the shoulder, which are small pouches filled with a liquid called synovial fluid. 

The inflamed connective tissue and adhesions cause shoulder pain and stiffness, which gradually worsens over time. Due to the progressive nature of this condition, people aren’t usually given a frozen shoulder diagnosis until a significant amount of time has passed. 

If you suspect that your shoulder problems could be the early signs of frozen shoulder, seek consultation with a frozen shoulder specialist.

The Stages of Frozen Shoulder Syndrome

man clutching shoulder in pain

Frozen shoulder syndrome has three stages, each of which can last for months, or even years. Frozen shoulder is notoriously difficult to diagnose, even for an experienced physical therapist or doctor, so here’s what to watch out for:

Freezing Stage

The first stage of frozen shoulder is also the most painful for many patients. The so-called “freezing” phase occurs over a period ranging from two to nine months. 

During this time, it begins with minor pain and limited range of motion, which can be easily mistaken for a minor rotator cuff tear or bursitis. This confusion leads many people to seek out conventional physical therapy to help manage their symptoms, but when these treatments fail to resolve the symptoms, and they get progressively worse, it’s a sign of the freezing phase of frozen shoulder syndrome. 

Frozen Stage

After the freezing phase, the shoulder becomes frozen for a period of several months, or in some cases up to a year. During the frozen stage, both the passive range and active range of motion in the shoulder is extremely limited and the external rotation of the upper arm is nearly impossible, which makes basic, daily tasks extremely painful, challenging and frustrating. 

Thawing Stage

When people finally reach the thawing phase of frozen shoulder, the shoulder begins to loosen up on its own, but this process can take anywhere from six months to two years without medical intervention. In some cases, people who do not seek treatment never recover full range of motion. 

Pain and stiffness persists through the thawing phase, but improves as patients strengthen and stretch their shoulder muscles. 

Stop Frozen Shoulder Before it Starts

woman holding arms overhead

If you are experiencing any of the symptoms of frozen shoulder, such as unexplained pain or stiffness, you should contact a frozen shoulder doctor for a consultation. 

If frozen shoulder can be identified and treated during the early stages, patients can avoid months, or even years, of nagging, painful symptoms that prevent them from enjoying daily activities.

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