Thyroid Patients: Could You Have Frozen Shoulder?

Man holding his shoulder in pain
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It often starts with difficulty moving your shoulder. You may also feel a dull, aching pain in your shoulder area. You could also realize that you are having increasing difficulty with daily activities that involve lifting your arms, such as brushing your hair or reaching for an item on a high shelf. You may even have worsening shoulder pain while sleeping.

If these symptoms sound familiar, you could have a condition called "frozen shoulder"—also known as adhesive capsulitis. While you may not realize it, frozen shoulder is more common in thyroid patients.

Let's take a look at frozen shoulder, along with its causes, symptoms, and how how it's diagnosed, and treated.

The Causes of Frozen Shoulder

It's not clear what specifically causes frozen shoulder, but it seems to be more common in women between the ages of 40 and 60.

Other risk factors or potential causes of frozen shoulder include:

  • Having an endocrine condition such as diabetes or thyroid disease, including both both hyperthyroidism and hypothyroidism.
  • Having a shoulder injury, shoulder surgery, shoulder trauma, or an immobilized shoulder.
  • Having a surgery that immobilizes your shoulder, such as breast surgery or open heart surgery.
  • Hormonal changes, such as perimenopause and menopause.
  • Cervical disk disease of the neck

Symptoms of Frozen Shoulder

Frozen shoulder symptoms usually develop slowly over time, and worsens gradually. Often, it appears with mild pain over the course of several months. The condition typically goes through three different stages, with different symptoms evident at each stage:

  • Freezing stage -The freezing stage is usually the most painful stage, with pain most severe in your outer shoulder area. In some cases, you may also have pain radiating down into your upper arm. Movement of your shoulder typically causes pain, and you may have pain while sleeping. Your range of motion in the shoulder is also typically reduced.
  • Frozen stage - During the frozen stage, the range of motion of your shoulder is even more limited and your shoulder becomes stiffer. It can become increasingly difficult to lift your arms up, or move your arms backward. Over time, the shoulder can become so stiff that it is almost impossible to move. You may notice a lessening of pain, however, as your shoulder becomes less mobile. 
  • Thawing stage - During the thawing stage, you typically will have less pain, with improvement to your range of motion over time.

Treatment for Frozen Shoulder

One of the challenges in treating frozen shoulder is getting an accurate diagnosis. In some cases, frozen shoulder is mistaken as rotator cuff pain, so an accurate diagnosis is essential to proper treatment. 

Frozen shoulder usually resolves on its own over time, but this can involve several years of pain and restricted mobility until the shoulder returns to normal. In some cases, full range of motion in the shoulder never returns to normal.

Experts have found that for those whose frozen shoulder is identified and diagnosed early, a cortisone injection directly into the frozen joint can help restore range of motion, and may help speed the healing time dramatically. (Note: many physicians do not recommend aggressive physical therapy at this time, as it can worsen the condition and prolong the recovery. Experts instead recommend gentle stretching as a complement to cortisone therapy.)

In some cases, pain medications such as nonsteroidal antiinflammatory drugs (NSAIDs) along with physical therapy/home exercises may be recommended. This treatment may help to restore the range of motion and relieve pain, but can take as long as a year for full relief.

Surgery for frozen shoulder is a last resort, but may be pursued if other options are not effective. Surgery—often performed arthroscopically—focuses on removing scar tissue and adhesions in the shoulder. Following surgery, a period of physical therapy is typically necessary to restore and maintain the range of motion in the shoulder.

A Word from Verywell

There are a few promising newer options to consider for frozen shoulder. They include transcutaneous electrical stimulation (TENS), which has been shown to significantly increase range of motion. Low-power laser therapy and deep heating (diathermy treatment) with stretching may also provide relief. 

 

 

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View Article Sources
  • Maund E, Craig D, Suekarran S, et al. "Management of Frozen Shoulder: A Systematic Review and Cost-Effectiveness Analysis." Health Technology Assessment, No. 16.11. Southampton (UK): NIHR Journals Library; 2012 Mar.
  • Page P, Labbe A. ADHESIVE CAPSULITIS: USE THE EVIDENCE TO INTEGRATE YOUR INTERVENTIONS. North American Journal of Sports Physical Therapy : NAJSPT. 2010;5(4):266-273.