Diagnosis

During the physical exam, your doctor may ask you to move in certain ways to check for pain and evaluate your range of motion (active range of motion). Your doctor might then ask you to relax your muscles while he or she moves your arm (passive range of motion). Frozen shoulder affects both active and passive range of motion.

In some cases, your doctor might inject your shoulder with a numbing medicine (anesthetic) to determine your passive and active range of motion.

Frozen shoulder can usually be diagnosed from signs and symptoms alone. But your doctor may suggest imaging tests — such as X-rays or an MRI — to 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

Over-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin IB, others), can help reduce pain and inflammation associated with frozen shoulder. In some cases, your doctor may prescribe stronger pain-relieving and anti-inflammatory drugs.

Therapy

A physical therapist can teach you range-of-motion exercises to help recover as much mobility in your shoulder as possible. Your commitment to doing these exercises is important to optimize recovery of your mobility.

Surgical and other procedures

Most frozen shoulders get better on their own within 12 to 18 months. For persistent symptoms, your doctor may suggest:

  • Steroid injections. Injecting corticosteroids into your shoulder joint may help decrease pain and improve shoulder mobility, especially in the early stages of the process.
  • Joint distension. Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint.
  • Shoulder manipulation. In this procedure, you receive a general anesthetic, so you'll be unconscious and feel no pain. Then the doctor moves your shoulder joint in different directions, to help loosen the tightened tissue.
  • Surgery. Surgery for frozen shoulder is rare, but if nothing else has helped, your doctor may recommend surgery to remove scar tissue and adhesions from inside your shoulder joint. Doctors usually perform this surgery with lighted, tubular instruments inserted through small incisions around your joint (arthroscopically).

Lifestyle and home remedies

Continue to use the involved shoulder and extremity 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 involves inserting extremely fine needles in your skin at specific points on your body. Typically, the needles remain in place for 15 to 40 minutes. During that time they may be moved or manipulated. Because the needles are hair thin and flexible and are generally inserted superficially, most acupuncture treatments are relatively painless.

Transcutaneous electrical nerve stimulation (TENS)

A TENS unit delivers a tiny electrical current to key points on a nerve pathway. The current, delivered through electrodes taped to your skin, isn't painful or harmful. It's not known exactly how TENS works, but it's thought that it might stimulate the release of pain-inhibiting molecules (endorphins) or block pain fibers that carry pain impulses.

Preparing for your appointment

While you might first consult your family physician, he or she may refer you to a doctor who specializes in orthopedic medicine.

What you can do

Before your appointment, you may want to write down:

  • Detailed descriptions of your symptoms
  • Information about medical problems you've had
  • Information about the medical problems of your parents or siblings
  • All the medications and dietary supplements you take
  • Questions to ask the doctor

What to expect from your doctor

Your doctor may ask some of the following questions:

  • When did your symptoms begin?
  • Are there activities that worsen your symptoms?
  • Have you ever injured that shoulder? If so, how?
  • Do you have diabetes?
  • Have you had any recent surgeries or periods of restricted shoulder motion?
March 10, 2015
References
  1. Skinner HB. Current Diagnosis & Treatment in Orthopedics. 5th ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://accessmedicine.mhmedical.com/book.aspx?bookid=675. Accessed Jan. 22, 2015.
  2. Frozen shoulder. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00071. Accessed Jan. 22, 2015.
  3. Prestgaard TA. Frozen shoulder (adhesive capsulitis). http://www.uptodate.com/home. Accessed Jan. 22, 2015.
  4. Acupuncture. National Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 22, 2015.
  5. DeSantana JM, et al. Effectiveness of Transcutaneous Electrical Nerve Stimulation for treatment of hyperalgesia and pain. Current Rheumatology Reports. 2008;10:492.