Frozen shoulder - aftercare

More about Your Injury

The joint capsule holds your bones together and allows them to move in between them.

• The joint capsule is made up ofligaments (that connect bones to each other), tendons (that attach muscles to bone), and other tissues.
• In frozen shoulder, the joint capsule swells from being inflamed. This keeps the shoulder bones from being able to move freely in the joint.

Frozen shoulder may develop with no known cause. It can also occur in people who:

• 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
• Have medical problems , such as thyroid disease, diabetes and menopause

What to Expect

The symptoms of frozen shoulder often follow this pattern:

• At first, you will have a lot of pain or a freezing feeling that prevents you from moving your arm.
• Then your shoulder will become very stiff and hard to move, but the pain will lessen. It will be hard to do things that you need to reach over your head or behind you to do.
• Finally, the pain goes away and you can use your arm again. This is the thawing phase and can take months to be over.

It can take a few months to go through these stages of frozen shoulder. The shoulder can get very painful and stiff before it starts to loosen up. And it may take as long as 18 -24 months for complete recovery. To help speed recovery, your health care provider will:

• Teach you some exercises to restore motion in your shoulder joint
• Refer you to physical therapy

Your health care provider may also advise you to have a steroid shot. The steroid medicine can reduce inflammation, and this can make you more comfortable. The medicine is injected into your shoulder joint.

Most people have a full recovery with full range of motion withoutsurgery.

Symptom Relief

Using moist heat on your shoulder 3 - 4 times a day may help relieve some pain and stiffness. Pain medicine you can buy without a prescription can also help.

• Some examples are ibuprofen (such as Advil or Motrin), naproxen (such as Aleve or Naprosyn), and acetaminophen (such as Tylenol).
• Before taking any of these medicines, talk with your health provider if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or bleeding.
• Do not take more than the amount recommended on the bottle.

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 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 housecleaning, taking out the garbage, gardening, and other household tasks.

Shoulder Exercises

You will learn some simple exercises and stretches for your shoulder.\

• At first, try to do these 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 health care provider, nurse, or rehabilitation therapist will show you how to do these exercises.

When to Call the Doctor

Call your primary health care provider if:

• The pain in your shoulder is getting worse.
• You re-injure your arm or shoulder.
• Your frozen shoulder is making you feel sad or depressed.

Alternate Names

Adhesive capsulits; Frozen shoulder syndrome

References

Krabak BJ, Banks NL. Adhesive capsulitis. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 10.

Update Date: 6/28/2012

Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.