Stiff Shoulder Syndrome and Parkinson’s Disease

A woman talking to doctor about shoulder pain

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Are your shoulders stiff? You may be suffering from stiff shoulder syndrome. Could it be from Parkinson’s disease?

Shoulder stiffness is, in fact, one of the conditions associated with Parkinson's disease, a neurodegenerative disorder caused by a lack of dopamine in the brain. Dopamine is a chemical that helps you to have smooth, coordinated muscle movements.

The bones, ligaments, and tendons that make up your shoulder joint are encased in connective tissues. Frozen shoulder (adhesive capsulitis) occurs when these tissues thicken and tighten around the shoulder joint, making it harder to move.

Nearly half of people living with Parkinson's disease report a history of adhesive capsulitis prior to the onset of Parkinson's symptoms. The peak incidence occurs around two years prior to the diagnosis of the disease.

Symptoms

With adhesive capsulitis, there will typically be a dull or aching pain in the outer shoulder area. Sometimes the pain occurs in the upper arm. The most frequent symptom of frozen shoulder is stiffness or restricted motion.

Adhesive capsulitis typically develops slowly in stages. Each of the three characteristic stages can last up to several months.

  • Freezing stage: Any movement causes pain, and your shoulder's range of motion is limited.
  • Frozen stage: Pain may begin to diminish but your shoulder becomes stiffer, and using it becomes more difficult.
  • Thawing stage: The range of motion in your shoulder begins to improve.

For some people, the pain worsens at night and can interrupt sleep. Adhesive capsulitis doesn't always recur in the same shoulder but can sometimes move to the opposite shoulder.

Diagnosis and Treatment

Adhesive capsulitis is diagnosed with a doctor's examination and a review of symptoms. In some cases, magnetic resonance imaging (MRI) or X-rays can help to rule out other potential causes of shoulder pain and stiffness.

Treatment for frozen shoulder involves range-of-motion exercises and, sometimes, corticosteroids and numbing medications injected into the joint. In a small percentage of people, surgery may help loosen the joint so that it can move better. Nonsteroidal anti-inflammatory drugs (NSAIDs) often aid in relieving acute pain.

Generally speaking, surgery is only considered if the pain is severe despite steroid injections and the shoulder stiffness persists four to six months in spite of physical therapy and other conservative measures.

A Word From Verywell

Although a stiff shoulder can develop in people with Parkinson's, the risk also increases in people with other diseases including diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease, and tuberculosis.

Most stiff shoulder treatment involves controlling shoulder pain and maintaining as much movement in the shoulder as possible. If symptoms persist or worsen despite adherence to treatment, ask your doctor to expand the investigation or refer you to an orthopedic surgeon.

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Article Sources

  1. Nagy MT, MacFarlane RJ, Khan Y, Waseem M. Suppl 3: The Frozen Shoulder: Myths and Realities. Open Orthop J. 2013;7:352-5. doi:10.2174/1874325001307010352

  2. Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017 Apr;9(2):75-84. doi:10.1177/1758573216676786

Additional Reading

  • Ford, B. and Pfeiffer, R.F. (2005). Pain syndromes and disorders of sensation. In: Parkinson’s Disease and nonmotor dysfunction. R.F. Pfeiffer and I. Bodis-Wollner (Eds). Humana Press, Totowa, New Jersey. Pps. 255-270.

  • Mayo Clinic. "Frozen shoulder."

  • Drake DF, Harkins S, Qutubuddin A (2005) Pain in Parkinson's disease: Pathology to treatment, medication to deep brain stimulation. NeuroReb 20:335 341.