What Is the Best Treatment for Frozen Shoulder?

Frozen shoulder is an extremely painful condition that can affect almost anyone. Characterized by pain and stiffness so intense that movement seems impossible, frozen shoulder is estimated to affect 3% to 5% of the general population.

At Keck Medicine of USC, Orthopaedic Surgery in the Boyle Heights neighborhood of Los Angeles, California, orthopaedic and sports medicine specialist George Hatch, MD, treats patients with all types of joint injuries, including frozen shoulder. Here’s what Dr. Hatch wants you to know about treatment for a frozen shoulder.

Frozen shoulder 101

Frozen shoulder (also called adhesive capsulitis) is a condition that causes pain, then stiffness, in the shoulder before a slow, long recovery. No one is precisely sure what causes frozen shoulder, although risk factors appear to be higher for the following groups:

• People over 40 (especially women)
• Those with thyroid conditions
• Diabetics
• Anyone who has had to immobilize their shoulder for a length of time
• Patients with Parkinson’s disease
• Cardiovascular disease patients
• Athletes who have suffered a rotator cuff injury

Most people who have frozen shoulder and recover don’t get it again in the same shoulder, although some patients do subsequently have frozen shoulder on the opposite side of their body.

Stages of frozen shoulder

There are three stages of frozen shoulder. The entire cycle typically lasts between one and five years.

Stage 1 

The first stage of frozen shoulder is pain that starts off as an ache or a twinge when the joint is used at the outer edge of range of motion. Pain increases rapidly until any movement of your shoulder causes severe pain, and range of motion decreases sharply. This stage can last anywhere from 2-9 months.

Stage 2

The second stage of frozen shoulder is stiffness. Pain may or may not start to slowly decrease at this stage, but the stiffness can make it even harder to move your shoulder. While you may be able to force yourself through some level of pain, stiffness can eventually almost completely immobilize your arm. This stage can last anywhere from 4-12 months.

Stage 3

The third stage of frozen shoulder is recovery. Most people with frozen shoulder eventually (after a year or so) start to see improvement in their pain and stiffness levels. Pain may seem worse at night, to the point of making it hard to sleep. This stage can last anywhere from 5-24 months.

The best treatment for frozen shoulder

There are multiple treatments for frozen shoulder. Most doctors, including Dr. Hatch, prefer to use the most conservative methods of treatment first. Only if a frozen shoulder is completely intractable and immune to conservative treatment is surgery recommended. The most effective modes of treatment work best when combined, and include:

• Anti-inflammatory oral medications
• Icing at regular intervals to relieve pain
• Corticosteroid injections into the shoulder capsule
• Physical therapy

These methods work for more than 90% of people, so conservative treatments appear to be the best way to manage frozen shoulder cases. If you do require surgery, Dr. Hatch can perform it arthroscopically using very small incisions and tiny tools to remove scar tissue in your shoulder joint.

To learn more about frozen shoulder and treatment, contact our office by calling 323-442-5860, or book an appointment online today with Dr. George Hatch of Keck Medicine of USC, Orthopaedic Surgery.