STAMFORD, Conn. -- Hospital for Special Surgery's Dr. Sabrina Strickland answers your questions on frozen shoulders.
What exactly is ‘frozen shoulder’? How would I know if I’m suffering from this condition?
A frozen shoulder is initially a painful shoulder without a history of trauma that then progresses to a painful stiff shoulder and eventually just a stiff shoulder. It is often difficult to diagnose, especially at the beginning. If you are experiencing shoulder pain and it is not improving with rest, I would recommend seeing a doctor specializing in shoulder issues.
How much should a patient be pushed for range of motion during physical therapy with various stages of frozen shoulder? Does working through pain further accelerate the inflammatory process of the capsule and makes it worse?
That is tricky – the shoulders should be stretched gently but not excessively. What’s most important for these patients is to teach them to avoid painful arcs of motion and simple stretches they should do at home. Sometimes working through pain can make it worse. For example, strengthening exercises done too early can often make a frozen shoulder worse.
What do you recommend for treating extremely painful cases of frozen shoulder?
My recommendation is usually a steroid injection, followed by two weeks of rest. Of course, this recommendation would follow a thorough exam of the patient.
Is the injection treatment effective with all stages of adhesive capsulitis or is it recommended for only a certain stage and certain type of frozen shoulder?
Injection is best for the early stages and most often ineffective for stages three and four.
Is frozen shoulder caused by muscle issues or nerve issues?
Neither, a frozen shoulder is an inflammatory process that usually arises out of the blue without a known cause. It is more common in women, patients with diabetes and those who have suffered from a frozen shoulder in the past.
Dr. Sabrina Strickland is an orthopedic surgeon at Hospital for Special Surgery’s Women’s Sports Medical Center. She practices at both the HSS Outpatient Center in Stamford and the hospital’s main campus in New York. She specializes in shoulder and knee surgery.