Frozen shoulder - aftercare
Adhesive capsulitis - aftercare; Frozen shoulder syndrome - aftercare; Pericapsulitis - aftercare; Stiff shoulder - aftercare; Shoulder pain - frozen shoulder
More About Your Injury
The capsule of the shoulder joint is made of strong tissue (ligaments) that hold the shoulder bones to each other. When the capsule becomes inflamed, it becomes stiff and the shoulder bones cannot move freely in the joint. This condition is called frozen shoulder.
Frozen shoulder may develop with no known cause. It can also occur in people who:
- Are 40 to 70 years old (it's more common in women, but men can still get it)
- Have thyroid disease, diabetes, or are going through menopause
- Have a shoulder injury
- Have had a stroke that makes them unable to use their arm
- Have a cast on their arm that holds their arm in one position
Swelling, damage, or bone changes around the rotator cuff in your shoulder can cause pain that puts a kink in the activities of your life. Let's talk about shoulder pain. The rotator cuff is a group of muscles and tendons that attach to the bones of your shoulder joint. The group allows your shoulder to move and keep it stable. The most common cause of shoulder pain is when rotator cuff tendons become inflamed or trapped in your shoulder. This is called rotator cuff tendinitis, or irritation of these tendons and inflammation of the bursa, small slippery fluid filled sacs that the tendons glide over. A rotator cuff tear, when one of the tendons is torn from overuse or injury, can also cause intense shoulder pain. Other causes of shoulder pain can include arthritis, bone spurs - bony projections, a broken shoulder bone, frozen shoulder, when the muscles, tendons, and ligaments in your shoulder become stiff, and shoulder dislocation. Most of the time, you can take care of your shoulder pain at home. Try putting ice on your shoulder for 15 minutes, then leave it off for 15 minutes, three or four times a day for a few days. Make sure you wrap the ice in cloth, so it doesn't give you frostbite. Take ibuprofen to reduce pain and swelling. Slowly return to your regular activities once you start feeling less pain. Sudden shoulder pain can be a sign of a heart attack. Call Emergency Services if you have sudden pressure or crushing pain in your shoulder, especially if the pain starts in your chest, jaw, or neck. If you fall on your shoulder and feel sudden intense pain, you should see a doctor because you may have torn rotator cuff or dislocated your shoulder. If you have had shoulder pain before, try using ice and ibuprofen after exercising. Learn proper exercises to stretch and strengthen your rotator cuff tendons and shoulder muscles. Also, physical therapy can help. Make an appointment and talk about your options.
What to Expect
Symptoms of frozen shoulder often follow this pattern:
- At first, you have a lot of pain, which can come on abruptly even without an injury or trauma.
- Your shoulder can become very stiff and hard to move, even when the pain lessens. It becomes hard to reach over your head or behind you. This is the freezing phase.
- Finally, the pain goes away and you can use your arm again. This is the thawing phase and can take months to end.
It can take a few months to go through each stage of frozen shoulder. The shoulder can get very painful and stiff before it starts to loosen. It can take as long as 18 to 24 months for complete healing. To help speed healing, your health care provider will likely do the following:
- Teach you exercises to restore motion in your shoulder joint.
- Refer you to a physical therapist.
- Prescribe medicines for you to take by mouth. These include drugs to reduce pain and inflammation in the shoulder joint.
- You may also need a shot of anti-inflammatory drug or steroid directly into the joint to reduce the inflammation.
Most people have a full recovery with full range of motion without surgery.
Symptom Relief
Using moist heat on your shoulder 3 to 4 times a day may help relieve some pain and stiffness.
For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.
- Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
- Do not take more than the amount recommended on the bottle or by your provider.
In Your Home
Get help setting up your home so that you can get to everything you need without reaching above your shoulders or behind your back.
- Keep the clothes that you wear most often in drawers and shelves that are between your waist and shoulder level.
- Store food in cupboards, drawers, and refrigerator shelves that are between your waist and shoulder level.
Get help with house cleaning, taking out the garbage, gardening, and other household tasks.
Do not lift heavy things or do activities that require a lot of shoulder and arm strength.
Shoulder Exercises
You will learn some simple exercises and stretches for your shoulder.
- At first, try to do these exercises once every hour, or at least 4 times a day.
- It is more important to do the exercises often than to do them for a long time each time you do them.
- Use moist heat before the exercises to help lessen pain and increase movement.
- The exercises should focus on stretching of the shoulder and range of motion.
- Avoid exercises to strengthen your shoulder until the range of motion has returned.
Some of the exercises are:
- Shoulder stretches
- Pendulum
- Wall crawl
- Rope and pulley stretches
- Movements to help with internal and external rotation, such as hand behind back
Your doctor or physical therapist will show you how to do these exercises.
When to Call the Doctor
Call your doctor if:
- The pain in your shoulder is getting much worse even if you take pain medicine
- You re-injure your arm or shoulder
- Your frozen shoulder is making you feel sad or depressed
References
Krabak BJ, Chen ET. Adhesive capsulitis. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 11.
Martin SD, Thornhill TS. Shoulder pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 49.
Version Info
Last reviewed on: 6/8/2022
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
