Diagnosing Frozen Shoulder

NYU Langone doctors are experts in diagnosing frozen shoulder, also called adhesive capsulitis. In this condition, the shoulder joint gradually becomes stiff and painful. It occurs when inflammation causes scar tissue to build up in the joint capsule. This capsule is a sac formed by strong, flexible bands called ligaments, which connect bones. In the shoulder, the capsule surrounds the ball-and-socket joint where the humerus, or arm bone, meets the glenoid, a shallow cavity on the shoulder blade.

Over time, frozen shoulder restricts the shoulder’s range of motion. As a result, it may feel “stuck” in place, limiting your ability to move your arm and causing pain that can make it difficult to sleep. Frozen shoulder can affect your ability to perform everyday tasks, such as reaching overhead to wash your hair or extending your arm to put on a coat.

The cause of frozen shoulder is unknown, but some conditions increase a person’s risk of developing it. These include diabetes, hyperthyroidism, hypothyroidism, stroke, and Parkinson’s disease. Also at increased risk are people who have had an injury to the shoulder, such as a rotator cuff tear; those who have had surgery to the breast, heart, neck, or spine; and those whose arm has been immobilized, as in a sling after an injury.

This condition is most common in people in their 50s and 60s. Women are more often affected than men.

Frozen shoulder typically occurs in three phases. In the first phase, the shoulder becomes increasingly painful and stiff over the course of three to six months. In the second phase, which can last up to three months, the pain lessens, but stiffness increases and range of motion decreases. In the final phase, the frozen shoulder “thaws,” meaning symptoms of pain and stiffness decrease and range of motion is regained.

Symptoms of frozen shoulder typically lessen on their own within two years. Treatment, which may include medication or physical therapy, is sometimes needed to relieve symptoms.

To diagnose frozen shoulder, your NYU Langone doctor asks about your symptoms and determines if you have any health conditions that may put you at risk. He or she also performs the following tests.

Physical Examination

Your doctor evaluates range of motion as you move your arm and shoulder and then as he or she moves your arm for you. Most people with frozen shoulder have difficulty extending the arm upward, away from the body, and lowering it again.

X-rays

Sometimes, an X-ray is used to rule out other conditions that can affect the shoulder, such as bursitis. X-rays use high-energy beams of light to create images of bones and other structures.

Ultrasound

Your doctor may use ultrasound to look for tears in the rotator cuff, a group of muscles and tendons that connect the humerus to the shoulder blade. Ultrasound uses high-frequency sound waves to see structures in the body.

MRI Scans

An MRI scan uses a powerful magnetic field and radio waves to create images of soft tissues inside the body. It can detect rotator cuff tears and determine if a tear is partial or complete.