Frozen shoulder is one of the most common shoulder problems. In Korea, it is called “shoulder of 50-somethings” because the symptom usually occurs in those in their 50s. It is also called “adhesive capsulitis of the shoulder” or “stiff and painful shoulder.”

In the early stages of this condition, most patients feel pain in their shoulder. Their shoulder motion becomes limited in all directions, especially when raising the arm in front or to the side.

They sometimes wake up at night because of the pain caused when they change position or when they press their body against their shoulder. Patients also can have difficulty doing daily activities such as combing their hair, taking their wallet out of their back pocket, scratching their back and or fastening a bra.

Most of the patients complain about such symptoms even without experiencing injury or accidents in the past.

There is a lot of pain when frozen shoulder patients move their shoulder. However, the specific pain spots are not detected when a doctor touches the shoulder joint and the surrounding area. There is also no reduction in muscular strength or sensory change in the shoulder.

To discover the possible causes of frozen shoulder, the patients need checkups using X-ray, ultrasound or MRI. Doctors will be able to detect any change in the muscles and bones that may have caused tightness of the shoulder capsule.

The most common cause of frozen shoulder is a tight shoulder joint capsule due to prolonged immobilization or inflammation. Occasionally, patients may have problems in one or more of their rotator cuffs, the tendons and muscles that surround the shoulder joint and work to elevate and rotate arms.

Regardless of what causes the symptoms of frozen shoulder, treatment is the most important thing. 

At the early stage, doctors usually prescribe oral anti-inflammatory medicines or give a steroid injection to control the inflammation and relieve the pain.

Patients then need to receive intensive physical therapy. Physical therapy starts with applying physical modalities such as hot packs, electrical stimulation and ultrasound heat and is followed by “manipulation,” a type of physical therapy to loosen up the muscles surrounding the shoulder joint thus increasing the range of motion.

Physical therapy is usually conducted three times a week. Depending on the seriousness of symptoms, patients would need three to four weeks of physical therapy in mild cases and six to seven weeks for more severe cases. Then, patients would regain enough shoulder motion to carry out their daily activities.

Here are some tips to check for possible frozen shoulder. You have difficulty putting on a jacket, putting things on the top shelf, fastening bra, etc. due to limited motion of the shoulder joint; or you have shoulder pain at night when you move your shoulder in a specific direction. In these cases, you need to visit a doctor who specializes in muscle, bone, ligament and joint problems such as a rehabilitation doctor.

I also advise you to do the following simple stretching exercises daily to prevent frozen shoulder. First, grasp the ends of a towel with each hand. Second, put one hand behind your ear and the other hand at your waist. Third, pull the towel with the hand behind your ear upward and then pull with the hand at your waist downward as if you were washing your back during a shower.

Unless you have had severe trauma or have tumors, most shoulder problems can be treated without surgery. If you have any symptoms, consult with a specialist first to find out the best treatment for you.

By Lee Kang-woo

Department of physical and rehabilitation medicine

Samsung Medical Center