Frozen shoulder

Diagnosis

During the physical exam, a health care provider might ask you to move your arm in certain ways. This is to check for pain and see how far you can move your arm (active range of motion). Then you might be asked to relax your muscles while the provider moves your arm (passive range of motion). Frozen shoulder affects both active and passive range of motion.

Frozen shoulder can usually be diagnosed from signs and symptoms alone. But imaging tests — such as X-rays, ultrasound or MRI — can rule out other problems.

Treatment

Most frozen shoulder treatment involves controlling shoulder pain and preserving as much range of motion in the shoulder as possible.

Medications

Pain relievers such as aspirin and ibuprofen (Advil, Motrin IB, others) can help reduce pain and inflammation associated with frozen shoulder. In some cases, a health care provider might prescribe stronger pain-relieving and anti-inflammatory drugs.

Therapy

A physical therapist can teach you range-of-motion exercises to help recover your shoulder movement. Your commitment to doing these exercises is necessary to regain as much movement as possible.

Surgical and other procedures

Most frozen shoulders get better on their own within 12 to 18 months. For severe or persistent symptoms, other treatments include:

• Steroid injections. Injecting corticosteroids into the shoulder joint might help decrease pain and improve shoulder mobility, especially if given soon after frozen shoulder begins.
• Hydrodilatation. Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint. This is sometimes combined with a steroid injection.
• Shoulder manipulation. This procedure involves a medication called a general anesthetic, so you'll be unconscious and feel no pain. Then the care provider moves the shoulder joint in different directions to help loosen the tightened tissue.
• Surgery. Surgery for frozen shoulder is rare. But if nothing else helps, surgery can remove scar tissue from inside the shoulder joint. This surgery usually involves making small incisions for small instruments guided by a tiny camera inside the joint (arthroscopy).

Lifestyle and home remedies

Continue to use the shoulder and arm as much as possible given your pain and range-of-motion limits. Applying heat or cold to your shoulder can help relieve pain.

Alternative medicine

Acupuncture

Acupuncture uses hair-thin, flexible needles put into the skin at certain points on the body. Typically, the needles remain in place for 15 to 40 minutes. The needles are not generally put in very far. Most acupuncture treatments are relatively painless.

Nerve stimulation

A transcutaneous electrical nerve stimulation (TENS) unit delivers a tiny electrical current to key points on a path that a nerve follows. The current, delivered through electrodes taped to the skin, isn't painful or harmful. It's not known exactly how TENS works. It might cause the release of molecules that curb pain (endorphins) or block fibers that carry pain.

Preparing for your appointment

You might first see your primary care provider. In some cases, you may be referred to a doctor who specializes in treating bones and muscles (orthopedist or physiatrist).

What you can do

Before your appointment, be prepared with:

• A complete description of your symptoms and when they began
• Information about medical problems you've had
• Information about the medical problems of your parents or siblings
• The names of all the medications and dietary supplements you take
• Questions to ask the health care provider

What to expect from your doctor

Be prepared to answer questions, such as:

• What worsens your symptoms?
• Have you ever injured that shoulder? If so, how?
• Do you have diabetes?
• Have you had recent surgeries or had to keep your shoulder still for a time?