There are actually two types of frozen shoulder, primary and secondary. Primary, or idiopathic, comes on spontaneously and the cause is still unknown. Primary frozen shoulder follows a pattern of three stages and is self-limiting (it gets better over time). Researchers have been able to identify related risk factors such as diabetes, cardiac disease and hypothyroidism. It also occurs more commonly in women than in men. The secondary type, or acquired type, typically follows an injury to the shoulder or arm in which the arm is immobilized for some time. Treatment will look different depending on the type.
Primary Frozen Shoulder follows three stages: a freezing stage, a frozen stage, and a thawing stage.
- Freezing Stage: During this stage the shoulder becomes extremely painful. Patients begin to notice decreased range of motion (ROM) and they commonly convey that their pain and discomfort is affecting their sleep patterns. This stage can last anywhere from 6 weeks to 9 months. Pain management is the main goal during this stage. Any therapy will be gentle stretching as the inflammation is growing during this phase. Your therapist may choose to hold therapy during this stage and have you focus on pain management and gentle stretching at home.
- Frozen Stage: During the frozen stage, the pain will change and can improve. Stiffness will remain, making activities challenging. The frozen stage may last 4-6 months. During this time, you will want to begin a therapy program which will get more vigorous as the pain subsides. Sticking to a daily stretching routine will help with improvement during this stage.
- Thawing Stage: Thawing occurs around month 7-9, but can take up to 2 years. During this stage, movement slowly improves. As with the frozen stage, diligence in a stretching and strengthening program is paramount to a full recovery.
Secondary Frozen Shoulder has a known cause, whether it is another injury or a period of immobilization following surgery. Secondary frozen shoulder does not have the same prognosis (final outcome) of primary, therapy is intensive from the start. Diligence in your therapy attendance and home program will be major determining factors in how you progress.
For more information, check out the American Academy of Orthopedic Surgeons website: http://orthoinfo.aaos.org/topic.cfm?topic=a00071
Do you suspect your shoulder is frozen? Unable to manage your shoulder pain? If so, you could be a candidate for hand therapy services at LB Hand Therapy in Maryland. Visit our Where to Begin page to become a patient.