Find out the difference between frozen shoulder and arthritis symptoms, and how to treat frozen shoulder without surgery.
The medical term for frozen shoulder is adhesive capsulitis, and it can be misdiagnosed as arthritis due to the similarity of symptoms.
In frozen shoulder, the tissue around the joint is chronically inflamed; this causes a thickening and tightening in the affected area.
Symptoms of Frozen Shoulder
Significant pain and restrictive movement. These symptoms are also common with other musculoskeletal conditions of the shoulder—such as arthritis.
The right diagnosis may require extensive investigation into one’s medical history.
“Adhesive capsulitis involves idiopathic [unknown cause] inflammation of the shoulder joint capsule, causing pain and decreased shoulder motion,” says Jessalynn Adam, MD, who specializes in primary care sports medicine with OrthoVirginia.
“There are three phases: freezing (the shoulder is painful and stiff), frozen (the shoulder is no longer very painful but motion is significantly restricted), and thawing (shoulder motion gradually returns to normal). This can be quite a prolonged process, up to 26 months.”
Is arthritis sometimes misdiagnosed as frozen shoulder syndrome?
“Perhaps, but age and other health conditions can help to differentiate the two,” says Dr. Adam.
“Frozen shoulder or adhesive capsulitis typically affects middle-aged women between the ages of 40-60.
“It is more common in those with autoimmune conditions such as diabetes, thyroid dysfunction, atherosclerotic/heart disease and Dupuytren’s contracture [a hand condition].”
Painful and Stiff Don’t Always Mean Frozen Shoulder
A report in the 2011 Journal of the American Academy of Orthopaedic Surgeons states that people who have a painful and stiff shoulder are often diagnosed with “frozen shoulder.”
But many things can cause motion loss in a joint.
Details of Frozen Shoulder Symptoms
- Inability to sleep on the affected side due to pain
- Movement so restricted that dressing is difficult, and other things as well like hair care such as shampooing.
- Pain will often decrease once the motion becomes quite restrictive, but pain will bite when the patient makes a sudden movement beyond the confinements of the stiffness.
This is because of microscopic tearing of the scar tissue.
Symptoms of Arthritis
When one tries to move the shoulder, there is often a ratchety or grinding sensation, which is not present with frozen shoulder syndrome.
An X-ray can show arthritis.
Treatment
“Physical therapy focused on capsular stretching, cortisone injected into the shoulder joint to reduce inflammation and pain, rest, time,” says Dr. Adam.
The stretching should be gentle and progressive over a period of weeks, even months sometimes.
“Most cases respond well to these treatments,” says Dr. Adam.
“Refractory cases can be treated with a high volume injection or manipulation of the joint under anesthesia.”
Surgery is a very last resort, but is rarely needed.
Dr. Adam
