You find it painful to brush your hair, carry your purse, or participate in your exercise class. Your shoulders are painful and you have less movement, but you know you did not injure yourself, so what could be the cause? Frozen shoulder, a little known but increasingly common condition tends to affect women during menopause. A frequent menopausal symptom amongst Japanese women, frozen shoulder is affecting women in greater numbers than ever before.

What is frozen shoulder?
Frozen shoulder or ‘adhesive capsulitis; is the inability to move your one or both shoulders, and is usually accompanied by pain.

Frozen shoulder in a nutshell
Your shoulder is made up of ligaments and tissues that help connect your arm bones to the shoulder socket, and these connective ligaments and tissues allow for the wide range of shoulder movement. Frozen shoulder occurs when the connective tissue becomes thicker and more rigid, further tightening the tissues which then become painful. You find it more difficult to move your shoulders if you can move them at all.

Unlike an injury to the shoulders, frozen shoulder begins gradually and builds in intensity over time, often lasting as long as two years. After this time, the shoulder begins to return to a more normal state or ‘thaws’ out. This pain is not considered to be arthritis because the pain tends to be concentrated in this specific area and does not spread to other joints in the body.

Symptoms of frozen shoulder
There are typically three stages of frozen shoulder, each stage having its own particular set of symptoms.

Pain stage: You start to notice pain in one or both shoulders, but cannot trace the discomfort to a specific injury. During this stage you notice a decrease in your mobility; you may not be able to reach above your head to grab an object off a shelf or style your hair. The shoulder joints become inflamed.

Frozen stage: By now your mobility is severely limited because the shoulder joints are very inflamed, and you are unable to perform most of your daily tasks. You might also find it difficult to sleep at night or to find a comfortable position while sitting.

Thawing stage: Gradually, just as you noticed your mobility decease, you begin to see some improvement. Your shoulders start to return to a more normal state and the pain lessens.

What causes frozen shoulder?
Usually, frozen shoulder is due to immobility of the shoulder. When someone has had their shoulder in a sling for a long time after an injury, frozen shoulder can set in. There are a variety of other causes including recovery from surgery, diabetes, overactive or underactive thyroid, or Parkinson’s disease. Menopause is also considered to be a link to frozen shoulder.

Who gets frozen shoulder?
Frozen shoulder mostly affects people over the age of 40. Sometimes frozen shoulder is referred to as Fifties Shoulder because it rarely occurs in younger individuals. In most cases, up to 70% of the time, women get frozen shoulder. While the research is still inconclusive, hormonal changes that occur during menopause may explain why women are more prone to this condition than men are.

Japanese women, menopause and frozen shoulder
Compared to other menopausal women, Japanese women tend to report frozen shoulder as the most common menopausal complaint. At this point, no one is really sure why Japanese women are affected or what exact role menopause plays.

Slowly, more women are reporting frozen shoulders in the United States, Canada, Australia, and other Western countries. With a large percentage of the population aging and more women going through menopause, the numbers of frozen shoulder sufferers is expected to rise in the next couple of decades.

Treatments for frozen shoulder
While most cases of frozen shoulder do ‘thaw’ out after several months or a couple of years, most patients will want relief in the meantime. Once your doctor has confirmed a diagnosis of frozen shoulder, he or she will likely suggest a combination of physical therapy and medication. Even though it is painful to move, keeping your shoulder moving is essential to strengthening the joints and muscles. Your doctor may prescribe a pain killer or anti-inflammatory drug to help ease the discomfort.

Additional treatments may include injecting sterile water into the shoulder joint to help distend or stretch the tissues. Surgery is considered as a last resort and only for the most severe cases.

Can I prevent frozen shoulder?
For women during menopause or peri-menopause, there may be no real ways to prevent or stop frozen shoulder from developing. If you notice any unusual shoulder pain or find it more difficult to move your shoulders, keep track of your symptoms and show them to your doctor.

Frozen shoulder is rarely discussed and rarely understood. But it does affect many women during menopause, and knowing what to look for can help you deal with this condition and prevent it from impacting your life.

Some very helpful sites for more information about frozen shoulder are:
www.mayclinic.com/health/frozenshoulder
www.sportsinjuryclinic.net

Menopause, Your Doctor, and You