You reach into your closet shelf for the scarf you threw up on the high shelf last week. But the scarf stays put. Your shoulder is so stiff that you can’t reach your arm over your head.
Maybe you try a hot compress or an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) to loosen your shoulder and dull the pain. But if your shoulder stiffness and pain don’t resolve within a few days, it’s time for a medical evaluation. Shoulder stiffness might be the beginning of a frozen shoulder that could significantly affect your quality of life.
At Next Step Orthopedics in McKinney, Texas, our expert orthopedist Dominique Nickson, MD, knows that stiff and painful shoulders can be caused by a variety of injuries. But the worst thing to do when you have a stiff or frozen shoulder is to do nothing at all.
Why your shoulder freezes
A normal, healthy shoulder is the most mobile joint in your body. You should easily be able to reach:
- Above your head
- Across your body
- Behind your back
- Side to side
When you have a frozen shoulder, the tissues inside your rotator cuff swell, thicken, and limit your range of motion. Your joint itself may be perfectly normal, without any identifiable fractures or tears.
There’s no single cause for a frozen shoulder. However, if you’ve stopped moving your shoulder for any reason — such as prior surgery or a broken arm — that lack of motion increases your risk for freezing. You’re also more likely to develop a frozen shoulder if you:
- Are older
- Wore a sling for a prolonged period
- Had a rotator cuff injury
- Have cardiovascular disease
- Suffered a stroke
- Have a thyroid condition
- Have diabetes or other conditions
When your shoulder feels stiff and painful, you’re probably tempted to limit its motion. However, restricting movement not only causes frozen shoulder in the first place, it worsens the stiffness over time.
The three stages of freezing
When you have a frozen shoulder, it goes through three distinct phases:
- Freezing — pain, with slow loss of motion over six weeks to nine months
- Frozen — less pain, but complete loss of motion for up to six months
- Thawing — gradual return of movement
Not only can you not move your shoulder on your own, your doctor may not be able to move it either. Without treatment, your frozen shoulder could take up to three years to completely “thaw.” During that time, you might not be able to perform normal daily tasks, including dressing yourself.
Diagnosing stiff and frozen shoulders
When you come to Next Step Orthopedics with a stiff or painful shoulder, Dr. Nickson conducts a comprehensive examination of your shoulder, including an evaluation of your range of motion. He first asks you to try to move your arm on your own to determine your shoulder’s active range of motion, and then moves your arm himself to determine your shoulder’s passive range of motion. If you have a frozen shoulder, both your passive and active motions are limited.
Dr. Nickson also takes a complete medical history and asks your about prior injuries. He may order imaging studies to determine if you have underlying injuries that prevent you from moving your shoulder freely, including:
- A rotator cuff tear
- A fracture
After Dr. Nickson diagnoses the causes of your stiff or frozen shoulder, he comes up with a treatment plan to restore your mobility and prevent further loss of motion.
Treating frozen shoulder
The goal of therapy is to reduce the inflammation and swelling inside the shoulder capsule that’s restricting your movements. Dr. Nickson may recommend:
- Corticosteroid injections
- Manipulation under anesthesia
- Shoulder arthroscopy
As part of your treatment and recovery, he recommends physical therapy. Daily stretching and strengthening exercises are essential to keeping your shoulder well-lubricated and moving smoothly.