Frozen shoulder, also known as adhesive capsulitis, is a painful and debilitating condition that affects a significant number of people, particularly women. This article delves into the causes, symptoms, and treatment options for frozen shoulder, shedding light on this often-overlooked health issue.
Imagine if one morning you casually reached back to hook your bra only to be greeted with a jolt of pain in your shoulder. And then instead of going away, the pain gradually got worse over time, to the point that you had to invent creative and weird ways to deal with your bra—and putting on a shirt, and washing your hair, and any number of mundane daily tasks. Imagine if eventually, you were so afraid to move your shoulder, it just got kind of…stuck.
That’s frozen shoulder, or what doctors (less dramatically) call adhesive capsulitis. It’s a mysterious condition, since there’s usually no specific injury that causes it, Sara Edwards, MD, an orthopedic surgeon at the University of California San Francisco, tells SELF. What is clear: Frozen shoulder is common, particularly among women in their 40s and 50s (right around the time that perimenopause begins), and it can be seriously debilitating—taking months to years to finally go away. Yet hardly anyone is talking about it. “That’s what I’m struck by,” Dr. Edwards says. “I see at least one patient a day who has frozen shoulder, and most have never heard of it before.” Here’s a primer on the signs of a deep freeze ahead, and what to do about it. Frozen shoulder 101 Frozen shoulder is caused by trouble in the joint capsule, Gabriella Ode, MD, a sports medicine specialist and surgeon at the Hospital for Special Surgery, in New York City, tells SELF. The shoulder joint capsule is basically a pocket of strong ligaments and lubricating synovial fluid that anchors and stabilizes the upper arm bone within the shoulder socket. With frozen shoulder, this capsule first becomes inflamed and thickened, which leads to stiffness and pain. Over time, bands of scar tissue can form—looking like “little cobwebs,” Dr. Edwards notes—while the synovial fluid may dry up too. Together, those conditions make it superhard to move your arm. In some cases, Dr. Ode says, frozen shoulder follows an injury or surgery that keeps you from moving the joint (what doctors call “secondary” frozen shoulder). Usually, though, frozen shoulder just happens with no identifiable cause. Who gets frozen shoulder? Around 5% of the population develops frozen shoulder, but it’s up to four times more common among women than men. And, as mentioned, women between the ages of 40 and 60 are particularly vulnerable. Many experts suspect that the hormonal changes of perimenopause are at least part of the explanation, Dr. Edwards says. “We do have estrogen receptors in our joints,” she points out, “and estrogen has anti-inflammatory effects.” Changes in estrogen levels during this time can contribute to an increase in inflammation, which is at the root of frozen shoulder. The problem is, not much research has been done on the subject. One small study did find that women who used menopausal hormone replacement therapy (HRT) were about half as likely as non-users to have frozen shoulder (3.95% versus 7.65%). But this area of research is in its early days, Dr. Edwards says, and no one has proven that taking hormones can ward off frozen shoulder. The study experts note that these results are preliminary and should spark more studies to determine if HRT is truly protective. Some other higher-risk groups include people with diabetes or thyroid disease, Dr. Ode says. It’s not clear why, but researchers speculate that the inflammation caused by those diseases might be one reason. The three stages of frozen shoulder Generally, doctors divide frozen shoulder into three phases: The freezing stage. First, there’s pain. Dr. Edwards says her patients often describe it as a dull throbbing in the shoulder that turns into a sharp argh when they move the affected arm certain ways—typically reaching overhead or to the back (the bra-hook scenario is a classic). It’s also common for the pain to worsen at night, Dr. Ode says. As this phase progresses (typically over the course of six weeks to nine months), the pain slowly intensifies, making it harder to move your arm. The frozen stage. At this point, the pain might lessen, but the shoulder remains stubbornly stiff. The frozen stage typically lasts four to six months (or sometimes longer). A “hallmark” of frozen shoulder, Dr. Edwards says, is that you have trouble moving it yourself and so does someone else, because there’s a physical blockage. The thawing stage. Finally, the pain and stiffness gradually loosen their grip. Unfortunately, it might feel like an iceberg melting: The thaw can take six months to two years—or longer for some people. Hillary Jackson, a dance teacher who lives outside New York City, is one of the “lucky” ones. She tells SELF that her frozen-shoulder saga, from initial symptoms to mostly getting back to normal, lasted about six months. Jackson first noticed something was wrong with her right shoulder in early 2017, when she was 4
Frozen Shoulder Adhesive Capsulitis Shoulder Pain Women's Health Perimenopause Joint Health
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