Stiff Shoulder

Stiff shoulder (adhesive capsulitis) is stiffness, pain, and limited range of movement in your shoulder. It may happen after an injury or overuse or from a disease such as diabetes or a stroke. The tissues around the joint stiffen, scar tissue forms, and shoulder movements become difficult and painful. The condition usually comes on slowly, then goes away slowly over the course of a year or more.
The shoulder has a spheroidal joint (ball – and – socket joint), in which the round part of one bone fits into the concavity of another. The proximal humerus (round head of the upper arm bone) fits into socket of the scapula (shoulder blade). Stiff shoulder is thought to cause the formation of scar tissue in the shoulder, which makes the shoulder joint’s capsule (not to be confused with the rotator cuff) thicken and tighten, leaving less room for movement. Therefore, movement may be stiff and even painful.

Symptoms of a stiff shoulder can vary in intensity and duration, but commonly include:

Pain: Persistent pain in the shoulder joint, often worsened with movement or pressure on the area.

Limited Range of Motion: Difficulty in moving the shoulder freely in different directions, such as reaching overhead, behind the back, or across the body.

Stiffness: Feeling of tightness or stiffness in the shoulder, particularly after periods of inactivity or upon waking up in the morning.

Weakness: Decreased strength in the shoulder muscles, which may affect daily activities like lifting or carrying objects.

Tenderness: The shoulder area may feel tender to the touch, especially around the joint or specific muscles.

Swelling: Inflammation and swelling around the shoulder joint, often accompanied by warmth or redness.

Clicking or Popping Sensation: Some individuals may experience clicking, popping, or grinding sensations when moving the shoulder, which can indicate underlying issues.

Difficulty Sleeping: Discomfort or pain in the shoulder can make it challenging to find a comfortable sleeping position, leading to disrupted sleep patterns.

Radiating Pain: Pain may radiate from the shoulder down the arm or up into the neck, indicating potential nerve involvement or referred pain.

Muscle Spasms: Involuntary muscle contractions or spasms in the shoulder area, contributing to pain and stiffness.

Several factors can increase the risk of developing a stiff shoulder. These risk factors include:

Age: The risk of shoulder stiffness tends to increase with age, as wear and tear on the joint and surrounding tissues accumulate over time.

Previous Shoulder Injuries: Individuals who have previously experienced shoulder injuries, such as rotator cuff tears, dislocations, or fractures, may be at higher risk for developing stiffness in the shoulder joint.

Medical Conditions: Certain medical conditions, including diabetes, thyroid disorders, autoimmune diseases (e.g., rheumatoid arthritis), and heart disease, can contribute to shoulder stiffness.

Prolonged Immobilization: Immobilization of the shoulder joint due to surgery, injury, or medical conditions can lead to stiffness as the joint loses flexibility and range of motion.

Poor Posture and Overuse: Incorrect posture and repetitive movements or overuse of the shoulder joint, such as in certain occupations or sports activities, can strain the muscles and ligaments, increasing the risk of stiffness.

Lifestyle Factors: Factors such as smoking, obesity, and sedentary lifestyle can impair blood circulation and contribute to inflammation, which may predispose individuals to shoulder stiffness.

Genetic Predisposition: Some individuals may have a genetic predisposition to conditions that affect the shoulder joint, increasing their susceptibility to stiffness.

Gender: Although shoulder stiffness can affect individuals of any gender, some studies suggest that certain conditions leading to stiffness, such as frozen shoulder, may be more common in women.

Occupational Factors: Jobs or activities that involve repetitive overhead movements, heavy lifting, or prolonged periods of arm elevation can increase the risk of shoulder stiffness.

Psychological Factors: Psychological stress and anxiety may exacerbate muscle tension and contribute to the development or worsening of shoulder stiffness.

For alleviating shoulder pain and inflammation, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen can be effective. If these medications prove insufficient, your doctor may prescribe stronger options.

Your therapy regimen may involve visiting a physical therapist for exercises aimed at enhancing strength and flexibility to improve your range of motion.

If symptoms persist or worsen, your doctor may recommend alternative treatments, including:

Joint Distension: Your doctor may perform a procedure involving the injection of sterile water into the shoulder capsule to stretch it, facilitating improved movement.

Physical Therapy: While results from physical therapy vary, it can be beneficial at specific stages of shoulder stiffness.

Surgery: Although rarely necessary, if other treatments fail to provide relief, surgery may be considered. This typically involves arthroscopic procedures using small instruments inserted through tiny incisions in the shoulder.

Shoulder Manipulation: This technique, once common but now rare due to advances in arthroscopic surgery, involves forcefully moving the shoulder tissue under general anesthesia. However, it carries a heightened risk of complications such as fractures.