In Japan and China, they call it “fifties shoulder” because it's a common symptom among women in menopause and midlife. In the west, it’s generally referred to as “frozen shoulder,” and among health care professionals, “adhesive capsulitis.”
By whatever name, a frozen shoulder is painful and limiting. So let’s talk about what it is, why it happens, and how to find relief.
Frozen shoulder is inflammation in the connective tissue of the “head” of your shoulder, the “shoulder capsule.” Over time, the tissue of the joint gets thicker and tighter, and adhesive bands of tissue can form in the joint. Full range of motion (particularly reaching over your head or behind your back) becomes more and more painful until finally it’s all but impossible.
Many sufferers say it happens in three stages: stiffening (or painful), frozen, thawing. The good news is, it can thaw, and with the right treatment and therapy, most sufferers can regain their full (or nearly full) range of motion, and eliminate or greatly reduce the pain.
We don’t entirely know why frozen shoulder happens. Sometimes it flares up all on its own, sometimes it may be the result of an earlier injury.
Frozen shoulder can also be hard to diagnose, since it’s generally identified by process of elimination (determining what it’s not, like a rotator cuff injury). Lots of folks let it go, believing it to be arthritis, but please don’t do that: it’s not arthritis, and because frozen shoulder is progressive, the sooner you catch it, the less you’ll suffer and the better the long-term prognosis.
The condition happens to around 3% of the population, most often in adults 40 – 65, and more commonly to women than men. It’s also more common among people with diabetes. It may happen so frequently in menopause because women lose the inflammation-dampening benefits of estrogen.
One possible explanation for frozen shoulder is our emotions and the body posture that results from those emotions. Says Jennifer Mason, acupuncturist and owner of Vitamin Chi: “Maybe you tighten up your back or roll your shoulders forward when you’re feeling defensive. A gentle noticing of how you hold your body and what tenses you can help here.”
Frozen shoulder can’t really be prevented unless you’ve suffered an injury to the shoulder that makes movement difficult. In that case, consult a doctor for advice on exercises that will keep the shoulder mobile.
If you’re already experiencing some stiffening and/or pain, don’t wait to get help.
Traditional therapies usually start with taking NSAIDs (anti-inflammatories like aspirin or ibuprofen), alternating ice and heat on the affected area, gentle stretching, and corticosteroid injections in the joint. Your doctor will likely suggest that you work with a physical therapist to slowly increase flexibility until the shoulder returns to normal. In some cases, surgery is an option: the two types are manipulation that stretches the tissue, and arthroscopy, which cuts through the tight tissues.
In addition to those therapies, there are other steps that might help relieve pain and increase motion. Here’s what Jennifer Mason suggests:
The majority of frozen shoulder cases resolve in time, but it can take up to three years to recover. Taking the right steps sooner rather than later can decrease the pain and duration of the condition and increase your chances of getting full usability back.
Something to bear in mind: while we do not recommend delaying treatment, we also know it's a real world out there. Some insurance companies do not cover treatments for frozen shoulder, or may not cover it completely. Because the disease often resolves over time, your insurance agency may insist that you "wait it out" rather than get treatment. So it's good to check before proceeding, and frankly, to advocate for coverage if you're told to grit your way through it. Women have compared the pain of frozen shoulder to childbirth, only it lasts a whole lot longer and doesn't result in a baby.
The information on the Gennev site is never meant to replace the care of a qualified medical professional. Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.