Frozen shoulder can make it difficult to raise the arm, reach behind the back, get dressed, sleep comfortably, or complete routine tasks. The condition typically progresses gradually, causing increasing pain and a substantial loss of shoulder motion.
Having completed more than 100,000 patient evaluations, Dr. Brian Cohen provides individualized frozen shoulder treatment in Columbus, OH. He considers the stage of the condition, degree of stiffness, underlying health, daily limitations, and response to previous care before recommending treatment.
What Is Frozen Shoulder?
Frozen shoulder, also called adhesive capsulitis, develops when the capsule surrounding the shoulder joint becomes painful, thickened, and tight. Bands of stiff tissue may form, making it increasingly difficult for the humeral head to move normally within the socket.
The condition restricts both active motion, when a patient moves the arm independently, and passive motion, when the arm is moved by someone else. This widespread stiffness commonly affects reaching overhead, reaching behind the back, dressing, bathing, driving, and sleeping.
Symptoms often improve gradually, but the condition may last many months or several years. Treatment can help manage pain, preserve function, and support the recovery of motion.
Diagnosing Frozen Shoulder
Diagnosis begins with a discussion of when the pain and stiffness started, how the symptoms have progressed, and which activities have become difficult.
Dr. Cohen or one of his orthopedic colleagues will compare active shoulder motion with passive motion. Frozen shoulder typically limits both, especially rotation of the arm and the ability to reach overhead or behind the back.
X-rays may be ordered to rule out arthritis, a fracture, or another bone-related cause of stiffness. MRI or ultrasound is not always necessary but may be used when symptoms suggest a rotator cuff tear or another soft-tissue condition.
Frozen Shoulder Causes and Risk Factors
In many cases, frozen shoulder develops without a clearly identifiable cause. This is sometimes called primary or idiopathic adhesive capsulitis.
The condition may also develop after the shoulder has remained relatively immobile because of:
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A fracture
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A rotator cuff or other shoulder injury
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A stroke or neurologic condition
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A stroke or neurologic condition
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Prolonged use of a sling
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Pain that discourages normal shoulder movement
Additional risk factors include:
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Diabetes
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Hypothyroidism or hyperthyroidism
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Middle age
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Female sex
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Certain neurologic or systemic health conditions
Patients recovering from surgery or injury should follow appropriate mobility instructions to reduce unnecessary stiffness without disrupting tissue or bone healing.
Frozen Shoulder Symptoms
The primary symptoms of frozen shoulder are pain and progressive loss of motion. They may include:
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A dull or aching pain in the shoulder
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Pain that extends into the upper arm
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Nighttime discomfort or difficulty lying on the affected side
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Increasing stiffness
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Difficulty raising the arm overhead
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Trouble reaching behind the back
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Difficulty dressing, grooming, bathing, or fastening clothing
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Reduced ability to drive, work, or exercise
The arm may feel weak because pain and stiffness prevent normal use. Significant weakness that remains when pain is controlled may suggest a rotator cuff injury or another shoulder condition.
Stages of Frozen Shoulder
Frozen shoulder commonly progresses through three overlapping stages:
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Freezing stage: Shoulder pain gradually increases, often becoming worse at night. Motion becomes progressively more limited.
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Frozen stage: Pain may begin to decrease, but stiffness remains pronounced, and daily activities can become difficult.
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Thawing stage: Shoulder motion gradually improves and activities become easier.
The length of each stage varies. Some patients improve within months, while others experience symptoms for several years. Recovery may also depend on underlying health conditions and the severity of the stiffness.
Frozen Shoulder Treatment Options
Treatment is intended to reduce pain, maintain useful shoulder function, and gradually restore motion. Recommendations depend on:
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The stage of the condition
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The severity of pain and stiffness
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Daily and occupational limitations
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Underlying health conditions
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Previous treatment
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The length of time symptoms have been present
Most patients begin with nonsurgical care. Manipulation or arthroscopic surgery may be considered when significant stiffness continues despite an appropriate treatment program.
Nonsurgical Treatment
Most frozen shoulders are initially treated without surgery. Care may include:
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Pain-relieving or anti-inflammatory medication when appropriate
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Heat or ice for symptom relief
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A corticosteroid injection into the shoulder joint
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Hydrodilatation to stretch the tightened capsule in selected cases
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Physical therapy or a physician-directed home exercise program
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Gradual stretching to improve motion
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Modification of activities that substantially increase pain
During the painful stage, therapy may focus on comfortable movement and symptom control rather than forceful stretching. As pain improves, exercises can progress to restore range of motion and shoulder function.
Corticosteroid Injection and Hydrodilatation
A corticosteroid injection may be recommended to reduce pain and inflammation within the shoulder joint, particularly during the earlier, more painful stage of frozen shoulder. Improved pain control may make exercises and daily movement easier.
Hydrodilatation, also called hydrodistension, involves injecting fluid into the joint to expand the tightened capsule. Medication may also be included in the injection.
These procedures do not guarantee immediate restoration of motion. They are typically combined with an appropriate stretching and rehabilitation program.
Manipulation Under Anesthesia
Manipulation under anesthesia may be considered when substantial stiffness and functional limitations continue despite appropriate nonsurgical treatment.
While the patient is under anesthesia, the surgeon carefully moves the shoulder through a controlled range of motion to stretch or release the tightened capsule. Physical therapy begins soon afterward to help maintain the motion gained during the procedure.
Potential risks include fracture, dislocation, rotator cuff injury, or nerve injury. Dr. Cohen reviews these risks and compares manipulation with continued nonsurgical care and arthroscopic treatment before making a recommendation.
Arthroscopic Capsular Release
Arthroscopic capsular release may be considered when pain and stiffness continue to substantially limit function despite an appropriate course of medication, injections, stretching, and physical therapy.
During the procedure, Dr. Cohen inserts a small camera and specialized instruments through small incisions. Tight portions of the shoulder capsule are carefully released to improve joint movement. Gentle manipulation may also be performed when appropriate.
The procedure does not eliminate the need for rehabilitation. Physical therapy begins soon afterward to preserve motion and reduce the risk of recurrent stiffness.
Why Choose Dr. Cohen?
OVER 25+ YEARS OF EXPERIENCE
One of the first orthopedic surgeons employed by a large hospital. Dr. Cohen spent 20 years.
TRUSTED BY OVER 100,000+ PATIENTS WORLDWIDE
Over his distinguished career, Dr. Cohen has cultivated a reputation of excellence and trust among his patients and his peers.
UTILIZING THE LATEST TECHNOLOGY
To achieve the best surgical outcomes, Dr. Cohen uses the most advanced technologies and techniques, keeping his practice state-of-the-art.
PATIENT SAFETY IS TOP PRIORITY
An individualized, patient-focused process coupled with decades of training and experience helps ensure maximum safety for all of Dr. Cohen’s patients.
Frozen Shoulder Care in Columbus, OH
Frozen shoulder can cause prolonged pain, stiffness, sleep disruption, and difficulty completing everyday activities. Dr. Cohen evaluates the stage of the condition, degree of motion loss, underlying health, and previous treatment before recommending therapy, injections, hydrodilatation, manipulation, or arthroscopic capsular release. To schedule a consultation with Dr. Brian Cohen, call (614) 788-0375.
