The first sign is often just a nagging ache, easy to write off as a strained muscle. But that dull pain can be the opening stage of frozen shoulder, a condition in which the capsule around the joint slowly thickens and locks the shoulder in place.
The American Academy of Orthopaedic Surgeons (AAOS) describes frozen shoulder as a condition that causes pain and stiffness and progresses until the shoulder becomes very hard to move.
The Cleveland Clinic explains that the shoulder joint capsule "becomes thick, stiff and inflamed," which restricts movement.
It shows up most often in adults between the ages of 40 and 60, and it affects women more often than men.
Also read: What a pinched nerve actually feels like: 7 warning signs by location
The three stages, and how long each lasts
Doctors describe the condition in three stages. AAOS lists the freezing stage as lasting 6 weeks to 9 months, the frozen stage 4 to 6 months, and the thawing stage 6 months to 2 years. Left to run its course, the full arc can drag on for one to three years.
7 warning signs of stage one
The early symptoms are exactly why so many people wait. They feel like an ordinary shoulder strain. Based on descriptions from AAOS and Cleveland Clinic, watch for the following signs.
- A dull or aching pain deep in the shoulder that is not tied to a specific injury.
- Pain that slowly worsens over weeks or months rather than appearing suddenly.
- Pain that gets worse at night and sometimes wakes you up.
- Difficulty raising the arm overhead, even for simple tasks like reaching a shelf.
- Trouble with routine motions such as reaching behind your back or grabbing a seatbelt.
- Sharper pain when you try to move the arm outward or rotate it.
- Loss of both active movement (you moving the arm) and passive movement (a clinician moving it for you).
Cleveland Clinic notes that the pain "may worsen at night" during the freezing phase, and that daily activities become harder as the joint stiffens.
Who is most at risk
Diabetes is the strongest known link. Cleveland Clinic estimates that "between 10% and 20% of people with diabetes develop frozen shoulder."
Also read: These foods may support your eye health
Thyroid disorders, Parkinson's disease, stroke, and heart disease also raise the risk, according to both AAOS and Cleveland Clinic.
Any period of shoulder immobility after a fracture, surgery or an injury that keeps the arm in a sling also raises the risk.
When to see a doctor, and what treatment looks like
Talk to a doctor if you have shoulder pain and stiffness that lasts more than a few weeks, especially if you cannot raise the arm normally or the pain interrupts sleep.
A physical exam that checks active and passive range of motion, sometimes with X-rays or ultrasound, is used to make the diagnosis.
Also read: Doctors compare cigarettes, vaping and cannabis - here is the biggest health risk
First-line treatment usually combines NSAIDs, physical therapy with stretching, and corticosteroid injections into the joint.
Surgery, such as manipulation under anesthesia or arthroscopic capsular release, is generally reserved for cases that do not improve after roughly a year of conservative care.
Also read: How eating sunflower seeds every day can affect your heart and immunity
This article is made and published by Mie Hermansen, who may have used AI in the preparation.