Frozen shoulder

Frozen shoulder affects about two percent of the general population, occurring more commonly in women between 40 years to 70 years old. The causes are not fully understood, but the process involves thickening and contracture of the capsule surrounding the shoulder joint, which causes pain and loss of motion or stiffness in the shoulder. A doctor can diagnose the condition based on the history of the patient's symptoms and physical examination. X-rays or MRI studies are sometimes used to rule out other causes of shoulder stiffness and pain, such as rotator cuff tear.

Risk Factors/Prevention
Frozen shoulder occurs much more commonly in individuals with diabetes, affecting 10 percent to 20 percent of these individuals. Other medical problems associated with increased risk of frozen shoulder include: hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease or surgery. The symptoms can develop after a shoulder is injured or immobilized for a period of time, so it best to move the shoulder as soon as possible after injury.

Symptoms
Pain due to frozen shoulder is usually dull or aching, which can worsen with attempted motion. The pain is usually located over the outer shoulder area and sometimes the upper arm. Restricted motion or stiffness in the shoulder is the main indicator. Some physicians have described the normal course of a frozen shoulder as having three stages:

Stage one: In the "freezing" stage, which may last from six weeks to nine months, the patient develops a slow onset of pain. As the pain worsens, the shoulder loses motion.

Stage two: The "frozen" stage is marked by a slow improvement in pain, but the stiffness remains. This stage generally lasts four months to nine months.

Stage three: The final stage is the "thawing," during which shoulder motion slowly returns toward normal. This generally lasts five months to 26 months. Physical therapy may help speed recovery.