Frozen shoulder issue for middle-aged people

When it comes to shoulder pain, people might expect problems to arise from an injury or a chronic issue with the joint.

What they might not expect is a traumatic shoulder pain that happens spontaneously.

“Frozen shoulder is an entity that is unknown in its cause,” said Dr. Eric Erickson, an orthopedic surgeon with ThedaCare Orthopedic Care. “It is quite strange that in 2022, we still can’t tell you why it occurs.”

When frozen shoulder happens, the lining of the joint, which is called the “capsule,” becomes inflamed and contracted, causing pain and loss of motion and pliability, Erickson said. This insidious problem progresses over time, causing ongoing discomfort including difficulty lying in bed at night. The loss of motion can lead to a high level of dysfunction for those who suffer from frozen shoulder.

“Then, at times, it will spontaneously ‘thaw out,’ where the pain decreases and the motion improves,” he said. “The difficult thing is that entire process can sometimes take 18 months to two years.”

While the cause is unknown, it most commonly impacts people in middle age, usually to the non-dominant arm, and people with diabetes are at a much higher risk of developing frozen shoulder, Erickson said.

“In people with diabetes, there are times where frozen shoulder will affect both shoulders, which is consequential,” he said.

For those patients whose symptoms improve without care, a significant number might experience some permanent loss of range of motion and can benefit from medical assistance.

“Here’s the reality: Most people aren’t going to tolerate frozen shoulder for 18 months to two years because their quality of life is so affected,” Erickson said. “Tolerating that impact to activities and to sleep is just a hard thing to do.”

Oral anti-inflammatories can decrease pain symptoms, as can an ultrasound-guided injection of cortisone.

“If you are trying to stretch a frozen shoulder, you’re stretching very inflamed tissue, and it can be quite painful,” Erickson said. “Many people will benefit initially from an injection of cortisone to really calm that severely inflamed shoulder, and that can then make the therapy afterwards much more effective and tolerable.”

Most people will improve after a cortisone injection and therapy, but it likely will not be resolved overnight, according to Erickson.