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Frozen shoulder (adhesive capsulitis)

The main joint in the shoulder is thought of as the 'ball and socket' joint of the shoulder, but actually it is more of a 'ball and saucer' with muscles, ligaments and tendons attached to make it more stable. There normally a tough capsule surrounding the joint which helps to hold the shoulder joint tightly together.

In the case of a frozen shoulder, the shoulder capsule becomes inflamed. When this occurs, then it may become overly tight from scar tissue, and cause pain and stiffness in the shoulder. This may take weeks or months to develop. For some people, over time the stiffness may disappear.

The stiffness is always there, especially when trying to raise the arm or placing the arm behind the back. When the shoulder is at rest there is minimal pain, but it usually will feel stiffer after a period of rest or inactivity. It may begin gradually, but sometimes may starts quickly over days or weeks. With no treatment the frozen shoulder may eventually 'thaw' , and return to normal. This may take many months or even years. Sometimes the stiffness does not improve, even with time.

The cause of frozen shoulder is poorly understood. It may be caused by previous overuse or abnormal use, or due to an injury. It seems to occur more frequently in people with diabetes. Sometimes frozen shoulder may follow open heart surgery.

Along with a history about shoulder symptoms, an examination using specific motions can suggest frozen shoulder is the diagnosis. Usually X-rays are done as well.

The treatment of frozen shoulder depends upon how severely it affects the function of the shoulder in that person, as well as how painful it is. Initial treatment often consists of physical therapy and exercises to reduce the stiffness in the joint, and this may reduce pain. Sometimes cortisone shots are tried. Medications such as Tylenol (generic = acetaminophen) Aleve (generic = naproxen), Motrin (generic = ibuprofen) or aspirin may be recommended to help the pain. They do not seem to help decrease the stiffness however. Various prescription medications which belong to a group of medications called

If you develop shoulder pain with exercise or exertion, please contact your physician as this may be a sign of heart disease.

If other treatments do not help, and the symptoms are severe, the shoulder joint may be stretched to break the adhesions by an orthopedic surgeon. This is usually done in the operating room when the patient is put to sleep, as otherwise it is very painful.

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