Frozen Shoulder (adhesive capsulitis)

Symptoms, Causes, Diagnosis & Treatments

By Mahnoush Rodriguez
Last Updated: September 9, 2018

❯ Shoulder Pain

Frozen shoulder is a shoulder condition that can lead to pain, stiffness and loss of range of motion.

In this article, you’ll get an overview of what a frozen shoulder is, what causes it and its symptoms and how it’s diagnosed and treated.

Important Note

DoctorsConvey does not provide medical advice, diagnosis or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Learn more

CONTENTS


overview-click

Overview


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Causes & Risk Factors​


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Signs & Symptoms


diagnosis_tests​-click

Diagnosis & Tests​


treatment_options​-click

Treatment Options​


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Home Care & Remedy​


overview-click

Overview


causes_risk_factors​-click

Causes & Risk Factors​


signs_symptoms-click

Signs & Symptoms


diagnosis_tests​-click

Diagnosis & Tests​


treatment_options​-click

Treatment Options​


home_treatment_remedy​​-click

Home Care & Remedy​

You can also download our free ebook to learn more about frozen shoulder.

Frozen Shoulder: Overview

overview-chapter1

What you learn in this chapter:

  • What is a frozen shoulder?
  • How does a frozen shoulder happen?
  • Alterations in shoulder joint
  • Frozen shoulder stages
    • Stage 1: painful phase
    • Stage 2: frozen phase
    • Stage 3: thawing phase

What is a Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a self-limiting but debilitating shoulder condition.¹

The painful stiffness of the shoulder joint can limit your shoulder range of motion and restrict your daily activities. 

About 0.75% to 2% of people develop adhesive capsulitis in their lifetime.
The incidence is much higher among diabetic people reaching 13.4%.²

How does a frozen shoulder happen?

Frozen shoulder occurs when there are inflammation and stiffness in the shoulder joint capsule.

Shoulder joint capsule

Shoulder joint capsule, also called articular capsule of the humerus, is the connective tissue that entirely surrounds the glenohumeral joint (shoulder joint).

In its normal state, this capsule is loose enough to allow smooth movement of inside structures.

If the body produces excessive scar tissue or adhesions in the shoulder joint capsule, it can cause frozen shoulder.³

Adhesions in the joint capsule are formed when bands of scar tissue connect two opposing tissue surfaces abnormally. 

Such adhesions can lead to stiffness, pain, and dysfunction.³

adhesions_shoulder_joint_capsule

Alterations in shoulder joint

Some of the physical characteristics of a frozen shoulder include:⁴

  • Thickening of the synovial capsule of the shoulder joint (glenohumeral joint)
  • Adhesions within the subacromial or subdeltoid bursa
  • Adhesions to the biceps tendon
  • Wasting of underarm muscles due to adhesions

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Frozen Shoulder Stages

Frozen shoulder starts with acute inflammation of the joint capsule followed by scarring and remodeling.¹

The typical progression of a frozen shoulder can be explained in three stages:³·⁴

Stage 1: painful phase

In this stage, also called freezing or inflammatory phase, the following changes can occur:

  • The shoulder starts to ache.
  • The pain becomes worse as the symptoms progress.
  • The active and passive range of motion becomes more restricted.
  • This stage typically lasts 3 to 9 months.

Stage 2: frozen phase

Most people progress to this stage which is also called the transitional or stiff phase.
The common characteristics of this stage include:

  • The individual may limit the use of the arm due to pain at the end of the range of motion.
  • This can lead to muscle disuse and atrophy.
  • The shoulder pain does not necessarily worsen at this stage.
  • External shoulder rotation may become the most limited followed by restrictions in shoulder flexion and internal rotation.
  • This stage typically lasts 4 to 12 months.
  • At the end of this stage, the pain may not occur at the end of the range of motion anymore.

Stage 3: thawing phase

In this stage, the individual may experience the following:

  • The range of motion starts to improve.
  • Shoulder mobility gradually returns.
  • This stage typically lasts 12 to 42 months.

However, the natural healing doesn’t happen to everyone, and the symptoms can become persistent in some people.³


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Frozen Shoulder: Causes & Risk Factors

causes_risk_factors​-chapter2

What you learn in this chapter:

  • What causes frozen shoulder?
    • Types of frozen shoulder
      • Primary frozen shoulder
      • Secondary frozen shoulder
  • Frozen shoulder risk factors
    • Frozen shoulder and diabetes
    • Shoulder immobility

Frozen Shoulder Causes

The underlying cause of frozen shoulder is not entirely clear and is still a matter of debate among medical professionals.

Types of frozen shoulder

Frozen shoulder can be classified into two main groups based on the cause:

  1. Primary frozen shoulder
  2. Secondary frozen shoulder
① Primary frozen shoulder

The primary frozen shoulder can happen spontaneously with no apparent external cause or trauma.³

Generally, the onset and progression of the symptoms are very gradual.
The symptoms may progress so slowly that the individual may not even seek medical attention until he or she experiences severe pain and loss of range of motion.⁴

This type of frozen shoulder can occur in both shoulders but rarely at the same time. The likelihood of developing it in both shoulders reaches up to 40-50% of cases.⁴

② Secondary frozen shoulder

There are two leading causes for secondary frozen shoulder:

  • Severe traumatic event
  • Surgery complications
► Severe traumatic event

The secondary frozen shoulder often happens after severe trauma to the shoulder joint.

An example is a fracture-dislocation in the shoulder joint after a fall.

In this condition, a break in the bony structures of the shoulder joint takes place, and at the same time, the joint gets dislocated.³

The subsequent immobilization of the shoulder after trauma can cause frozen shoulder.⁴

► Surgery complications

The secondary frozen shoulder can also happen after a shoulder surgery if the operation results in severe complications.

Examples are open or arthroscopic shoulder surgery including rotator cuff repair and shoulder replacement surgery.³

surgery_complication

Frozen Shoulder Risk Factors

Many factors have been identified that increase the risk of frozen shoulder development.
Some of them include:

  • Gender

Women are more prone to the development of frozen shoulder, especially in their perimenopause phase.¹

About 70% of the population with frozen shoulder are females.
However, women seem to respond better to treatments than men.³

risk_factor_gender_female

  • Age

People between 40 to 59 years old are at a higher risk.

It is estimated that 84% of people with frozen shoulder belong to this age group.³

risk_factor_age_range

  • Presence of other disorders

Frozen shoulder is more common among people with endocrine disorders or thyroid disease or those who have undergone breast cancer care such as mastectomy.¹

Some of the conditions associated with frozen shoulder include ³·⁴

  • Diabetes: Both the type I and type II diabetes increase the risk.
  • Thyroid disease: Overactive thyroid (hyperthyroidism) and underactive thyroid (hypothyroidism) can increase the risk.
  • Hypoadrenalism: Underactivity of the adrenal glands called hypoadrenalism is a risk factor.
  • Surgical procedures: Surgical procedures that don’t involve the shoulder are also risk factors. Such surgeries include cardiac surgery, cardiac catheterization, neurosurgery, and radical neck dissection.
  • Parkinson’s disease
  • Cardiac disease
  • Pulmonary disease
  • Stroke
  • Genetics

According to recent research, genetics may play a role in the development of frozen shoulder.
The prevalence of frozen shoulder seems to be higher among white people, those with a positive family history and individuals with positive HLA-B27.³

Human Leukocyte Antigen B27 (HLA-B27)

HLA-B27 is a type of protein found on white blood cells that help the body’s immune system. A positive HLA-B27 lab test indicates the body is at a higher risk for developing particular autoimmune disorders such as spondyloarthritis.

Spondyloarthritis is a form of arthritis that involves joints as well as ligaments and tendons where they attach to the bones.

Frozen shoulder and diabetes

Diabetes is one of the most common conditions that coexist with frozen shoulder. Diabetic people are 5 times more likely to develop frozen shoulder compared to non-diabetic individuals.²

In fact, about 11% to 30% of people with frozen shoulder also have diabetes.²·⁵

risk_factor_diabetes

The frozen shoulder also appears at a younger age among diabetic people.
The condition also seems to be more severe and respond less to treatment and last longer.²

There is no significant difference between the prevalence of frozen shoulder among type 1 and type 2 diabetes or if the person is on oral therapy or insulin therapy.²

Shoulder immobility

The pain from a frozen shoulder can prevent, restrict, or reduce normal movement of the affected shoulder.

Prolonged immobilization of the shoulder joint can cause further damage to the shoulder and lead to other types of shoulder problems.⁴


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Frozen Shoulder: Signs & Symptoms

signs_symptoms-chapter3

What you learn in this chapter:

  • Frozen shoulder symptoms by stage
    • Stage 1: painful phase
    • Stage 2: freezing stage
    • Stage 3: frozen stage
    • Stage 4: thawing stage

Always seek the diagnosis from a medical professional.

Symptoms mentioned below are commonly associated with this condition but can also appear in other shoulder problems. So it is crucial you seek an accurate diagnosis from your doctor or other qualified health care professionals.

Frozen Shoulder Symptoms

The symptoms of a frozen shoulder can vary as the condition progress.

The typical progression of symptoms can be categorized into 4 stages:⁶

Stage 1: painful phase

  • Gradual onset of symptoms
  • A dull, aching pain
  • Pain usually felt in the deltoid over the shoulder joint
  • Inability to sleep on the affected side
  • A mild limitation of range of motion
  • Symptoms typically persist less than 3 months

Stage 2: freezing stage

  • Severe pain
  • Pain at night and aggravated pain when lying on the affected side
  • A significant loss of both active and passive range of motion
  • Symptoms usually continue for 3 to 9 months

Stage 3: frozen stage

  • Shoulder stiffness is predominant
  • Pain may still be present at the end of the range of motion or at night
  • Symptoms usually persist for 9 to 14 months

Stage 4: thawing stage

  • Minimal pain
  • Gradual improvement of range of motion
  • This stage usually takes 15 to 24 months

Frozen shoulder is a chronic condition with slow progression and healing process.
It can take years before its symptoms get entirely resolved,⁴ and in some cases, the symptoms may never fully resolve.⁷


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Frozen Shoulder: Diagnosis & Tests

diagnosis_tests​-chapter4

What you learn in this chapter:

  • Frozen shoulder diagnosis
    • Medical history
    • Physical examination
  • Additional diagnostic tests
    • Conventional radiography (X-rays)
    • Magnetic resonance imaging (MRI)
    • MR arthrography

Frozen Shoulder Diagnosis

To diagnose frozen shoulder, your doctor asks for your medical history and conducts a thorough physical examination.

Medical history

Your doctor may ask when and how the pain started, the level of your physical activity, prior injury or trauma, the nature and duration of your symptoms such as pain and weakness and so forth.

doctor_takes_medical_history

Physical examination

After taking your medical history, your doctor examines your shoulder thoroughly.

shoulder_physical_examination

Many conditions can mimic the symptoms of frozen shoulder.

During the physical exam, your doctor tries to rule out other causes of a painful and stiff shoulder such as rotator cuff defects and subacromial bursitis.
This helps to confirm the presence of a frozen shoulder.⁴

Additional Diagnostic Tests

Sometimes, the medical history and physical exam are not enough to make a diagnosis.

The only way for definitive diagnosis of frozen shoulder is through direct surgical observation such as arthroscopy.
However, it is not usually necessary since diagnostic imaging can help to supplement the history and physical examination.⁷

Common imaging tests include

  • Conventional radiography (X-rays)
  • Magnetic resonance imaging (MRI)
  • MR arthrography

► X-rays

In this test, your body is exposed to x-ray radiation to take radiographic images.
Dense tissues in your body such as bones block the radiation and appear white in the image.
The less dense tissues such as muscles pass most of the radiation and appear gray.

X-ray images can help your doctor to rule out other possible causes of shoulder pain and loss of motion such as glenohumeral arthritis.¹

Sometimes x-ray can reveal osteopenia due to disuse. A prolonged frozen shoulder can show signs of disuse osteopenia.³

shoulder_x_ray

Disuse osteopenia

Disuse osteopenia occurs when you have lower bone density than normal due to immobilization and physical inactivity.⁸

► MRI

MRI or magnetic resonance imaging combines a powerful magnet and radio waves to create images by a computer.
Instead of x-rays, MRI uses a magnetic field.

An MRI picture provides a high level of detail. It is mainly used to get visibility into organs and soft tissues such as tendons and joints.

MRI images can help your doctor assess the status of shoulder joints and ligaments and investigate abnormalities in your shoulder.

mri_scan_diagnostic_imaging

► MR Arthrography

Magnetic resonance (MR) arthrography is a two-step imaging technique that uses contrast dyes to highlight the joint when taking images.

1. First step
During the first step called arthrogram, a contrast solution is injected into the joint to increase visibility into its structure.

2. Second step
The second step is to take MRI images of the joint.

mr_arthrography_diagnostic_imaging

MR arthrography is usually considered when a higher level of sensitivity and specificity is required.⁹
This imaging technique allows your doctor to better detect additional damages in the shoulder joint.

MRI and MR arthrography may reveal thickened coracohumeral ligament or joint capsule in the rotator cuff interval. This can help with the diagnosis of frozen shoulder.¹⁰


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Frozen Shoulder: Treatment Options

treatment_options​-chapter5

What you learn in this chapter:

  • Frozen shoulder treatment options
  • Frozen shoulder conservative treatment
    • Physical therapy
    • Anti-inflammatory oral medication
    • Intra-articular joint injections
      • Shoulder cortisone injection
      • Hyaluronate injections
    • Frozen shoulder hydrodilatation
  • Frozen shoulder surgery
    • Manipulation under anesthesia
    • Shoulder arthroscopic capsulotomy
    • Shoulder open capsulotomy

Always seek treatment from a medical professional.

Numerous factors affect the treatment choice. Your doctor will pursue a course of treatment that’s suitable for your individual health needs and risk factors.

Frozen Shoulder Treatment

Frozen shoulder may heal on its own in 1 to 3 years. But it’s possible the individual develops long-lasting symptoms.
In fact, studies have shown that 20-50% of people with frozen shoulder develop long-term limitations of range of motion that can last up to 10 years.⁴

The primary goals of treatment are to relieve pain and restore joint function.³

There are two main treatment options for this condition:

  1. Conservative treatment
  2. Surgical treatment

Frozen Shoulder Conservative Treatment

Since there is a likelihood for natural healing, no general treatment strategy exists for this condition.
Doctors tailor the treatment course based on the person’s needs, stage of the condition, and risk factors.³

► Physical therapy

Physical therapy is often one of the first treatments prescribed for frozen shoulder.
Many doctors recommend physical therapy after the painful phase.
Once the pain subsides, shoulder mobilization exercises become more tolerable.³

shoulder_physical_therapy_exercise

Physical therapy may be combined with other types of treatment such as electrotherapy or corticosteroid injection to increase its effectiveness.³

Early mobilization with physical therapy is generally recommended by medical professionals.
However, there is no consensus as to what techniques have the best outcome.
For example, some recommend gentle therapy while others prefer aggressive mobilization techniques that surpass the pain limits.
There is also no general agreement over the frequency of therapy.³

► Anti-inflammatory oral medication

Non-steroidal anti-inflammatory drugs (NSAIDs) or oral corticosteroids may be prescribed for a short period of time to manage symptoms.³

NSAIDs are often prescribed during the early inflammatory stages.³ However, they can be used during any stage for short-term pain relief.⁴

Anti-inflammatory medications may also be prescribed during the physical therapy.
The primary objective is to reduce pain so the individual can tolerate physical therapy and improve range of motion.³

oral_medication

► Intra-articular joint injections

Intra-articular injections are shots that are delivered directly into the joint. 

Common types of shoulder joint injections include:

  1. Shoulder cortisone injection
  2. Hyaluronate injections

injections

1. Shoulder cortisone injection

Intra-articular corticosteroid injection also called cortisone shot can improve pain and range of motion quicker and better than oral corticosteroids treatment.⁶

Adverse effects of shoulder cortisone shots seem to be more common among women.
Examples of such effects can be facial flushing and irregular menstrual bleeding.³

2. Hyaluronate injections

Also referred to as hyaluronic acid, sodium hyaluronate injections can improve pain and range of motion.⁶

Research has shown that intra-articular sodium hyaluronate injections can provide equivalent outcomes to cortisone shots, but with fewer side effects.⁶

Hyaluronate doesn’t seem to cause any complications, and its use is generally considered to be safe.³

► Frozen shoulder hydrodilatation

Hydrodilation, also called arthrographic distension, is a treatment technique which involves an injection of saline solution or corticosteroids into the joint capsule.⁶

The injection has a high enough pressure that can expand and stretch out the contracted joint capsule.¹¹

It can also break up the adhesions that might be limiting the shoulder movement.⁶

This procedure is performed under fluoroscopy.³
The fluoroscopy shows real-time moving X-ray images of the shoulder joint.

During the procedure, the individual will be under local anesthesia.
Since the entire shoulder is not anesthetized, the pain can be too much for some people to endure.⁴

Frozen Shoulder Surgery

Shoulder operation is often performed when the conservative treatment fails to deliver results.

Surgery might be considered if the individual has gone through conservative therapy for at least 2 to 6 months but shows no progress or the range of motion is worsening and the person has significant pain and shoulder limitations.¹·⁴

There are several options to treat frozen shoulder surgically such as:

  1. Manipulation under anesthesia
  2. Shoulder arthroscopic capsulotomy
  3. Shoulder open capsulotomy

① Manipulation under anesthesia

In this technique, the individual is put under general anesthesia, and the doctor forcibly moves the affected shoulder joint beyond its normal pain threshold.
This is to tear the scar tissues and break up adhesions and stretch the contracted joint capsule.
Some of the joint movements performed during this procedure include flexion, abduction and external rotation of the adducted humerus.³·¹¹

This method can improve shoulder range of motion and can allow early physical therapy after treatment.
However, tissues that are stretched during the procedure may cause pain when the individual awakens from anesthesia.⁴

The effectiveness of manipulation under anesthesia is a matter of debate.⁶
It is not clear if this technique is better than daily mobilization exercises or provides any superior outcome compared to hydrodilation and corticosteroid injection.¹¹

The safety of this technique is also controversial since there is a risk of shoulder damage during the procedure.
Examples are the humeral or glenoid fracture, shoulder joint dislocation, and rotator cuff tears.³·¹¹

Manipulation under anesthesia seems to be less effective for diabetic people with frozen shoulder.³
The likelihood that they experience poor outcomes and frequent recurrences is more than non-diabetic people.⁶

② Shoulder arthroscopic capsulotomy

Also known as arthroscopic capsular release and repair, arthroscopic capsulotomy is a minimally invasive procedure performed under general anesthesia.¹¹

In this surgical technique, a small incision is made in the skin on the shoulder to insert a narrow instrument called arthroscope.
The arthroscope is a tube with a fiber-optic video camera attached to it. It allows the surgeon to view the inside of the shoulder joint and examine it without the need for a large cut.
To perform the operation, the surgeon makes additional small incisions to insert specially designed pencil-thin surgical instruments.

In this procedure, the surgeon uses arthroscopic instruments to release the tightened structures with the contracted joint capsule.⁴

This method has two main advantages:³

  • The diagnostic part of the procedure allows to confirm the presence of a frozen shoulder and at the same time inspect other abnormalities in the shoulder.
  • Contrary to hydrodilatation and manipulation under anesthesia, it enables the surgeon to have direct visualization of the joint to ensure adequate release.

If the joint manipulation is necessary to restore range of motion, it can be done before, during, or after the procedure.⁴

Arthroscopy is generally considered to be effective in treating resistant frozen shoulder.⁶ Studies have shown that it has a good success rate in reducing the duration of the condition and restoring shoulder range of motion.⁴

Because of smaller surgical wounds, arthroscopic surgery is believed to shorten the recovery time and allow earlier postoperative rehabilitation.³

The formal physical therapy after the surgery can usually take 2 to 20 weeks and the total recovery time with a pain-free range of motion can be 1 to 6 months.⁴

③ Shoulder open capsulotomy

Open capsulotomy, also called open release, is a surgical technique in which part of the deltoid muscle is detached to perform the surgery.

Due to an invasive nature of this method, it is usually reserved for cases where arthroscopic capsulotomy has failed to improve pain and range of motion.³

Several studies have confirmed the effectiveness of open capsulotomy for treatment of resistant frozen shoulder.⁶


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Frozen Shoulder: Home Treatment & Remedies

home_treatment_remedy​​-chapter6

What you learn in this chapter:

  • Importance of self-education
  • Shoulder pain management
    • Trigger point therapy
    • Tens therapy
    • Shoulder pain massage
      • Shiatsu massage
      • Deep tissue massage
    • Acupuncture for shoulder pain
    • Heat and ice therapy
    • OTC topical pain relief
  • Frozen shoulder exercises
  • Nutrition and diet

Always consult with your doctor before trying any home treatments.

Health needs and risk factors are different for everyone. This means not every home treatment and remedy mentioned below is appropriate for you. Ask your doctor or health care provider to see which one is safe and effective for you.

Educate Yourself​

To manage symptoms of frozen shoulder and speed up the healing process, you can do several things at home that can supplement your doctor’s instructions and treatments.

The most important one is to educate yourself about this condition.

The more you know about the frozen shoulder, the better you can help yourself get through it and recover.

“Books are the quietest and most constant of friends; they are the most accessible and wisest of counselors, and the most patient of teachers.”

Charles William Eliot, 21st president of Harvard University

learn_about_condition

There are many useful online resources and educational books that have illustrations and instructions on how to prevent, treat and control shoulder problems.

FREE eBook: Frozen Shoulder

The more you know about your shoulder condition, the better prepared you are to improve it.

Get the ebook

These resources can help you in two ways:

  • You can ask better questions from your doctor or therapist
  • You can explore new ways to restore your health

Take advantage of them and learn as much as you can. You won’t be disappointed!

Shoulder Pain Management

Pain is the primary symptom of frozen shoulder, especially in its early stages.
Below methods may help you manage your shoulder pain. However, some of them don’t have medical evidence backing them, so their effectiveness and safety are not medically proven.
Still, many people find these methods helpful.

► Trigger point therapy

Trigger point therapy is a type of deep tissue massage.
In this method, pain is managed by pressing or rubbing trigger points.

A trigger point is like a muscle knot that can be the source of pain felt in another part of the body.

Trigger points, also called myofascial trigger points, are a controversial topic in the medical field. This is perhaps because there is no clear understanding of the nature and mechanism of these points.

trigger_point_taut_band_nodule

Regardless of the lack of medical evidence, some people find it helpful in relieving their pain.


EXTRA: Trigger Point Therapy

Learn more about trigger point therapy and how you can do it at home to relieve pain.

Trigger point release tools

You can do this therapy by yourself at home using the below tools.

These devices enable you to reach and stimulate trigger points all over your body.

Buy one of them and start the therapy to ease your pain:

trigger_point_self_massage_tool
Self-massage tool
massage_stick
Massage stick
foam_roller
Foam roller
lacrosse_balls
Lacrosse balls

► Tens therapy

TENS is short for transcutaneous electrical nerve stimulation.
In TENS therapy, a device called TENS unit is used to send electrical pulses to the skin for pain relief.

shoulder_tens_therapy

EXTRA: TENS Therapy Pain Relief

Learn more about TENS therapy and how you can do it at home for pain relief.

TENS unit

You can get a TENS unit and do this therapy at home.
TENS units are small and portable, and you can use them even at work or on the go.

Buy one of the below best-selling units and relieve your shoulder pain.

nursal_tens_unit
NURSAL TENS Unit
healthmateforever_YK15AB_tens_unit
HealthmateForever YK15AB
tens_7000
TENS 7000 2nd Edition

► Shoulder pain massage

Everybody likes a good massage!
A properly done massage by a therapist can help you relieve tension and pain in your shoulder.

However, always consult with your doctor before doing any massage therapy to make sure it is safe for you and your body can tolerate it without causing any complications.

shoulder_pain_massage

Massage types

There are many massage techniques each using a different method to manipulate the body.
Below are two common pain relief massages:

  • Deep tissue massage

Deep tissue massage is a technique that penetrates deep into muscle tissue to relieve pain and tension.

This method is more of an aggressive type and might be painful to go through for those who can tolerate only a light massage.

deep_tissue_shoulder_massage

  • Shiatsu massage

Shiatsu is a Japanese massage technique done by hands.

In this technique, the therapist applies pressure using his or her thumbs, fingers, and palms.

shoulder_massage_shiatsu

Self shoulder massage

Going to a therapist for a good massage is not your only option. You can get a body massager and do it yourself.

Here are some benefits of a self-massage:

  • You decide where, when and how much massage you want to receive
  • You are in control of its intensity and pressure level
  • You don’t need to get an appointment, take time off from work or pay each time you get a massage.
Body massagers

There are body massagers that can replicate hand movement of a massage therapist.

Buy one of the below massagers and enjoy a self-massage in the comfort of your home.

deep_kneading_shiatsu_massager
Deep-kneading Shiatsu Massager
deep_tissue_percussion_massager
Facial & Deep Tissue Percussion Massager
deep_tissue_massager
Deep Tissue Percussion Massager

► Acupuncture for shoulder pain

Acupuncture is another non‐drug therapy to treat shoulder pain. However, its effectiveness or safety isn’t yet proven by medical research.¹²

In this method, thin needles are inserted into the body to relieve chronic pain.

Acupuncture therapy seems to work by ¹²

  • stimulating the body to release chemicals that ease the pain
  • suppressing pain signals in the nerves
  • allowing energy or blood to better flow in the body

During the treatment, the therapist inserts the needles around the shoulder and upper arm.

acupuncture_shoulder_pain

You can get an appointment with a qualified acupuncturist and try this therapy to ease your shoulder pain.

► Heat and ice therapy

One of the conventional methods to manage swelling, stiffness, and pain is heat and ice treatment.

heat_ice_treatment

Putting ice on your shoulder can help reduce inflammation and pain, and the heat treatment can help relax sore muscles of your shoulder.

Heat and ice affect the blood flow in different ways:

  • Heat increases the blood flow
  • Ice reduces the blood flow

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Shoulder ice pack and heating pad

You can use an ice pack and a heating pad to do heat and ice therapy for pain relief.

Use a towel during the therapy, so these products don’t touch your skin directly. That’s because extreme heat or cold can damage your shoulder tissues.

Since both heat and ice impact the blood flow, don’t apply them for too long. Application of heat or ice for too long can result in tissue damages such as frostbite or skin dehydration and burn.

Buy one of the below products to manage your shoulder pain at home:

shoulder_ice_pack
Gel Ice Pack
shoulder_dual_hot_cold_therapy
Dual Hot Cold Wrap
shoulder_heating_pad
Heating Pad

► OTC topical pain relief

You can also use over-the-counter topical pain relievers to ease your shoulder pain.

These products come in different forms and shapes and can alleviate muscle pain and soreness.

  • Pain relief cream and gel
  • Pain relief patch
  • Pain relief spray
  • Pain relief roll-on

shoulder_topical_pain_relief

Frozen Shoulder Exercises

As frozen shoulder advances, stiffness and loss of range of motion become more apparent.

Stretching and exercise help to improve your shoulder strength, flexibility, and mobility. It can also help with pain reduction over time.

cross_body_reach_shoulder_exercise

During your treatment and rehabilitation, your doctor or therapist will give you a set of exercises to do at home.

There are also many online resources and books that explain shoulder stretches and exercises step by step.
Take advantage of them. But always consult with your doctor or therapist to make sure such stretches and exercises are appropriate for you.

Shoulder rehab tools

Many shoulder rehab exercises require physical therapy tools to engage the right muscles and joints.

Below tools are the most common shoulder rehab equipment that you can buy and use for your rehabilitation exercises at home:

shoulder_finger_ladder_exercise
Shoulder finger ladder
shoulder_resistance_band_exercise
Resistance Bands
shoulder_pulley_exercise
Overhead Shoulder Pulley


EXTRA: Shoulder Ladder Exercise

Learn more about shoulder ladder exercise and how you can do it at home.

Nutrition and Diet

Your overall health and fitness can influence your symptoms and recovery.
In addition to exercise, a healthy diet with nutritional supplements can positively impact your health and wellness.
But always check with your doctor before taking any supplements.

anti-inflammatory_diet_herbal_supplement

  • Anti-inflammatory diet

Foods that fight inflammation like Mediterranean diet can help with pain and inflammation reduction.

  • Dietary and herbal supplements

Supplements may be helpful in reducing inflammation and pain and improving overall joint health and prevent re-injuries.

Examples are supplements that contain omega-3 (fish oil), Glucosamine and Chondroitin with MSM, turmeric or ginger.


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Considerations

Please note that the information compiled in this article is from a variety of sources and it may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. Always seek the advice of a doctor or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Learn more

REFERENCES

[1] Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2017). Current medical diagnosis and treatment 2018 (57th ed.). New York: McGraw-Hill.

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