Frozen Shoulder Treatment & Chiropractic Care

What is frozen shoulder?

Frozen shoulder, known medically as adhesive capsulitis, is a condition in which the capsule of connective tissue around the shoulder joint becomes inflamed, thickened and tight. As the capsule contracts, it leaves less room for the ball of the upper arm bone to move in its socket, so the shoulder becomes painful and stiff.

The key feature is a loss of motion in every direction — not just pain when you lift your arm. People often notice it first when reaching overhead, fastening a bra, tucking in a shirt or reaching into the back seat of the car. Pain is frequently worse at night, especially when lying on the affected side.

The three stages of frozen shoulder

Frozen shoulder usually develops gradually and moves through three overlapping stages. Each stage can last several months, and the whole process often takes a year or more.

1. Freezing stage. Pain builds and the shoulder starts to lose motion. This is usually the most painful phase, and night pain is common.
2. Frozen stage. Pain often eases, but the shoulder is at its stiffest. Everyday tasks that need reach or rotation become difficult.
3. Thawing stage. Motion slowly returns. Many people regain most of their movement, although some are left with a degree of stiffness.

Knowing your stage matters, because the right amount of stretching in the frozen stage can be too aggressive during the painful freezing stage.

Causes and risk factors

It isn't fully understood why frozen shoulder develops, but some groups are clearly more likely to get it:

• Age and sex — it is most common between about 40 and 60 and affects women more often than men
• Diabetes — people with diabetes have a noticeably higher risk, and symptoms can be more stubborn
• Thyroid conditions, both overactive and underactive
• A period of immobility, such as after a rotator cuff injury, a broken arm, surgery or a stroke
• Other conditions including cardiovascular disease and Parkinson's disease

It rarely returns in the same shoulder, but some people later develop it in the other shoulder.

Is it frozen shoulder or something else?

Several problems can look similar at first: a rotator cuff tear or tendinopathy, shoulder impingement, arthritis of the shoulder joint, or pain referred from the neck. Your first visit includes a full orthopedic and neurological exam to check how the shoulder moves both actively and when we move it for you, which helps tell these apart. If the findings suggest a tear, arthritis or another problem that needs imaging, we'll refer you for it. Shoulder pain that travels from the neck is covered on our neck pain page.

How our chiropractors treat frozen shoulder

Frozen shoulder treatment without surgery aims to calm pain and keep as much motion as possible while the capsule recovers. Depending on your stage and exam, your plan may include:

• Gentle joint mobilization of the shoulder, kept within a tolerable range so it doesn't flare the joint
• Adjustments to the upper back and neck, since stiffness there changes how the shoulder blade moves and can add to strain on the shoulder
• Soft-tissue therapy and massage therapy for the rotator cuff, chest and upper trapezius muscles that tighten up to guard the joint
• The Deep Muscle Stimulator, a percussive tool used to relax dense, tight muscle around the shoulder blade
• A progressive exercise plan drawn from our sports injury treatment programs, so you can keep working on motion between visits

We often work alongside your physician. Medical options such as anti-inflammatory medication or a corticosteroid injection can reduce pain, particularly early on, which can make exercise easier. For the small number of people who don't improve with conservative care, a specialist may discuss other procedures. You can read more about our overall approach on our chiropractic treatment page.

Frozen shoulder exercises to try at home

Gentle, regular movement is the backbone of recovery. Common starting exercises include:

• Pendulum swings — lean forward with your good hand on a table and let the sore arm hang and circle slowly
• Finger walks — walk your fingers up a wall in front of you, only as far as is comfortable
• Towel stretch — hold a towel behind your back with both hands and use the good arm to gently draw the sore arm upward
• Cross-body reach — use the good arm to ease the sore arm across your chest

Aim for mild stretching discomfort that settles quickly, not sharp pain. Warming the shoulder with a heat pack or a warm shower first often helps. If an exercise leaves your shoulder sorer the next day, scale it back and ask your chiropractor to adjust the plan.

When to seek urgent medical care

Shoulder pain is not always coming from the shoulder. Call 911 or go to an emergency room if shoulder or arm pain comes with chest pain or pressure, shortness of breath, sweating or pain spreading to the jaw — these can be signs of a heart attack.

Get prompt medical attention if:

• You can't lift your arm after a fall or injury, or the shoulder looks deformed
• The joint is red, hot and swollen, or you have a fever
• You have unexplained weight loss or constant pain at night that doesn't change with position
• You notice weakness, numbness or tingling spreading down the arm

For the stiff, aching shoulder that has slowly lost its reach, a chiropractic exam is a sensible first step. Frozen shoulder is one of many conditions we treat across our clinics.