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Q
Freeing a Frozen Shoulder?

Could you please explain "frozen shoulder" and its causes?  What is the appropriate treatment?

A
Answer (Published 1/9/2003)

Updated on 6/22/2005

Frozen shoulder (the medical term is adhesive capsulitis) is a painful condition that can also limit arm movement on the affected side of the body. It is probably the result of an inflammatory process that causes the capsule surrounding the shoulder joint to thicken and contract. As a result, the upper arm bone (humerus) has less space in which to move.

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While the exact cause is unknown, frozen shoulder tends to develop after injury, overuse, or surgery that causes a period of immobility. Women are affected more often than men, and between 10 to 20 percent of diabetics eventually develop frozen shoulder. Hyperthyroidism, cardiovascular disease, Parkinson's disease and clinical depression can also be predisposing factors.

Symptoms typically begin with pain that worsens when you move your arm. Eventually the pain lessens but the range of motion in the affected arm decreases, preventing you from raising it overhead or rotating it outward. Such ordinary activities as reaching into the back seat of a car and even driving (particularly if your car has a manual transmission) can become difficult. This can go on for months, even years.

A combination of medication and home exercise or physical therapy can help relieve the pain and restore range of motion (visit the American Academy of Orthopaedic Surgeons at www.orthoinfo.aaos.org for more information). Conventional treatment also includes over-the-counter anti-inflammatory drugs such as aspirin or ibuprofen, muscle relaxants and the application of heat or ice for pain control. Some doctors recommend cortisone injections to suppress inflammation if other measures don't help. Arthroscopic surgery to repair the shoulder is a last resort, followed by an exercise program to keep the shoulder mobile.

Before resorting to such drastic measures, I would try acupuncture and osteopathic manipulation; both can be helpful, and both are safer than more invasive measures. I also recommend trying DMSO (dimethyl sulfoxide) topically. You can buy it at your health food store or on the Internet. It penetrates the skin and promotes healing of pockets of inflammation. Make a 70 percent solution of DMSO by diluting a 100 percent solution with distilled water and apply it to the shoulder with absorbent cotton. Let it dry. Apply the solution three times a day for three days. If you don't see any improvement, stop using it. If you do notice improvement, cut back to twice a day for three more days, then once a day for a final three days. After that your body can continue healing on its own.

Andrew Weil, M.D.

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