Also known as adhesive capsulitis, frozen shoulder is a condition in which the tissues in the shoulder joint become thick and tight, limiting the shoulder’s range of motion.
The condition develops in three stages, lasting a total of two to nine months.
How Frozen Shoulder Progresses
In the freezing stage, movement of the shoulder causes pain and the shoulder’s range is limited. In the frozen stage, pain begins to diminish, the shoulder becomes stiff and daily tasks are difficult to accomplish. In the thawing stage, the shoulder’s range of motion begins to improve.
Causes and Risk Factors
Individuals who have recently had surgery and had to immobilize their shoulder for an extended period time, or those with a hormonal imbalance, diabetes, or a weakened immune system may be at greater risk of joint inflammation.
Individuals 40 years of age and older, especially women, are more likely to have frozen shoulder. Individuals with the following conditions may be at increased risk:
- Diabetes (3x greater risk)
- Overactive thyroid (hyperthyroidism)
- Underactive thyroid (hypothyroidism)
- Cardiovascular disease
- Parkinson’s disease
Diagnosing Frozen Shoulder
A doctor will first perform a physical exam to assess the patient’s range of motion. The doctor will ask the patient to perform specific movements, such as touching their opposite shoulder with their hand.
Diagnostic imaging tests, such as an MRI or X-ray, may be performed to rule out a tear in the rotator cuff or other conditions.
Side Effects and Risks of a Subscapular Nerve Block
A subscapular nerve block can help treat pain affecting the shoulder and improve its range of motion. The procedure is generally safe, with very low risk. Common or possible side effects include:
- Increased pain
- Vascular injection
What to Expect During the Procedure
A suprascapular nerve block involves injecting a local anesthetic and a steroid to block the nerves that transmit pain signals from the shoulder. Patients may choose to receive no sedation or have sedation delivered orally or by IV. Patients that decide to be sedated must not eat or drink for six and four hours, respectively, before the procedure.
During the procedure, the patient lies on their stomach and the doctor begins by cleaning the injection site with an antiseptic. A local anesthetic will then be used to numb the affected area. Guided by fluoroscopic x-ray technology, the physician will find the correct spot to insert the needle and inject the medication.
After the Procedure
Patients may feel weak or have a numb sensation at the injection site. Patients who were sedated should not drive or engage in physical activity for 24 hours following the injection.
After the numbing medication wears off, patients may experience an increase in pain. However, once the steroid begins to work, patients will experience longer-lasting pain relief.
To speed up recovery, patients may need physical therapy, medication and home care. Physical therapy will help stretch the shoulder joint and improve the range of motion. Patients can perform simple exercises on a daily basis and expect to see an improvement in their condition.
Anti-inflammatory medication like aspirin, ibuprofen or naproxen sodium can help patients treat their pain and reduce joint inflammation.
Home care may involve placing an ice pack on the shoulder for 15 minutes, several times a day, to alleviate the pain.