How can I loosen a frozen shoulder?

DEAR DOCTOR K:

Is there any way to unfreeze a frozen shoulder?

DEAR READER:

The term “frozen shoulder” describes a condition in which pain and stiffness cause a loss of the normal range of motion. I saw a patient with a frozen shoulder a few months ago who could not scratch his back when it itched. He had to ask his family for help to take a book off an overhead shelf. Fortunately, a frozen shoulder can usually be unfrozen — if you have the time, patience and willingness to experience a little pain.

Normally, the shoulder has a wide and varied range of motion. Like the hip, the shoulder is a ball-and-socket joint. The rounded head of the bone of the upper arm (the humerus) sits in a scooped-out indentation of another bone, the scapula (commonly known as the shoulder blade). The meeting of the humerus and scapula is called the glenohumeral joint.

A frozen shoulder usually begins when injury or overuse causes pain that, in turn, limits the shoulder’s range of motion. Common conditions that cause pain in the shoulder are bursitis or a tear in the rotator cuff (a group of muscles and tendons in the shoulder).

If you don’t move your shoulder much at all for many weeks, the tissue surrounding the shoulder joint thickens and shrinks. It loses its ability to stretch. When you try to move it even a little, it hurts. So to avoid the pain, you move the shoulder even less. As a result, the joint capsule stiffens even further. It’s a vicious cycle. A frozen shoulder can take months to develop.

Try this experiment: Stick your hand out straight in front of you at eye level. Then move it all the way up until your fingers are pointing to the ceiling, and then all the way down. Then stick your arm straight out to the side and move it all the way up and down. Now try running the tip of your thumb up the middle of your back.

If in any of these maneuvers you heard or felt a little “click” or “pop,” a part of your shoulder had started to stiffen — and you just loosened it up again. If you found that you couldn’t do some of these maneuvers at all because of pain or stiffness, you might already have a frozen shoulder.

An anti-inflammatory medication such as aspirin, ibuprofen (Motrin, Advil) or naproxen (Aleve) can help relieve pain and inflammation. A corticosteroid injection may help decrease inflammation.

But the cornerstone of treatment is physical therapy. At first you’ll concentrate on exercises that stretch the joint capsule. Then you’ll move on to strengthening exercises. (Click here for some examples of stretching and strengthening exercises that can help a frozen shoulder.)

Full recovery can take several months or even longer. If you don’t improve steadily, go back to your doctor or consult a shoulder expert. In rare cases, a frozen shoulder that doesn’t respond to the treatments I’ve discussed may require surgery. Fortunately, that’s not often necessary.

Related Information: Neck and Shoulder Pain