Shoulder pain from a frozen shoulder can make it difficult to move, but a frozen shoulder will typically only worsen if you stop using it. This is when a frozen shoulder massage or stretches can be beneficial. While it may be difficult, especially at first, keep moving in order to keep your shoulder from completely freezing. Always check with your doctor first, but once you get the okay, here are some massages and stretches you may be able to do.

Do I have frozen shoulder syndrome?

Frozen shoulder syndrome (adhesive capsulitis) is a condition that occurs when the range of motion in your shoulder joint is so limited that it feels almost as if the shoulder is frozen in place. At the extreme end of this condition, patients are unable to move their shoulder at all. There may be intense shoulder pain as a result, and daily activities may be impossible to complete.

The cause of this type of pain is usually trauma, repetitive motions, or disuse. If a person stops using their shoulder due to pain or injury, it will naturally become stiff. Chronic health conditions such as diabetes or stroke may also cause someone to stop using their shoulder. Scar tissue can begin to develop in the shoulder capsule, effectively “freezing” it in place. The shoulder capsule then becomes inflamed and extremely painful to move.

If you believe you have a frozen shoulder, your doctor will do a thorough medical exam. This may include X-rays, magnetic resonance imaging (MRI), or ultrasound. You will also need to provide a detailed medical history that focuses on previous injuries or family history of medical conditions that put you at a higher risk for developing frozen shoulder syndrome.

Risk factors

While anyone can develop frozen shoulder syndrome, it occurs most often in people between the ages of 40 and 70. Other risk factors of frozen shoulder syndrome include:

• Gender: Women are more likely than men to have frozen shoulder syndrome.
• Injury or immobility: Rotator cuff injuries, broken arms, stroke, or recovery after surgery on the arm, hand, or shoulder itself can all result in prolonged disuse. This can lead to frozen shoulder syndrome.
• Disease: Doctors are not sure why certain diseases put patients at risk. These diseases include diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease, Parkinson’s disease, and tuberculosis. Diabetes in particular increases your risk. Ten to 20% of diabetes patients will develop this condition at some point.

Stages of frozen shoulder syndrome

There are three stages to frozen shoulder syndrome, each of which has its own symptoms.

Stage 1: Freezing

As this stage begins, patients may experience increasing pain in their shoulder accompanied by decreasing range of motion.

In response to the increased pain, patients may stop moving their shoulder, which only exacerbates the condition. This stage can last anywhere from six weeks to nine months.

Stage 2: Frozen

During this stage, patients may not experience much pain, but movement may become impossible.

Range of motion is greatly diminished or disappears completely, even to lift the arm up a few inches. Daily life becomes challenging during this stage.

Stage 3: Thawing

This recovery period of frozen shoulder syndrome can last anywhere from six months to two years, depending on the severity and amount of scar tissue built up.

Shoulder range of motion gradually returns to normal. Pain decreases substantially or is eliminated entirely once inflammation is under control.

How frozen shoulder massage or stretches can help

Massage therapy and routine stretches can significantly improve your pain associated with frozen shoulder syndrome.

By increasing blood flow to the area, your muscles can relax and inflammation will improve. This can reduce swelling and tenderness, not just in the shoulder, but also in the surrounding area. The decrease in pain typically leads to increased range of motion.

How to perform a frozen shoulder massage yourself

While massages are beneficial for frozen shoulder, it may not be possible to get them from a professional on a regular basis. Professional massages can be expensive and time consuming, making it difficult to maintain. For this reason, many people learn how to perform a frozen shoulder massage at home.

Note: Make sure to check with your doctor before adding any of these massages to your routine.

To start, one of the best ways to perform a shoulder massage is by using a foam roller. Place it underneath the armpit of your affected arm and lean on a counter or table. Extend your arm out as if you’re reaching for something and gently roll back and forth to loosen the muscles in your shoulder. You can also use this tool to gently massage your shoulder by placing it in between your shoulder and neck. See an example of this in the following video.

If you prefer not to use a foam roller, an effective method of massage for frozen shoulder involves massaging the arm and shoulder with your good hand. While you massage the shoulder muscles, slowly move your arm through a wide range of motion to gently stretch the muscles in your shoulder, as well as the surrounding area.

Some patients also find relief by using various electronic massage tools. They come in different shapes and sizes and usually operate with pulsating or vibrating movements. This can put pressure on trigger points in your shoulder, easing tension and improving circulation in the area. If you have limited range of motion because of the pain you’re experiencing, this can be a helpful option.

10 frozen shoulder stretch routines

As with any physical routine, talk to your doctor before taking up a new regimen. While it’s good to push yourself to recover, it’s important to avoid further injury.

Try the following frozen shoulder stretches at home once approved. Repeat each ten to 20 times per day, according to your own pace and pain level.

1. Pendulum stretch

For those with extreme pain, the pendulum stretch is a way to naturally relieve the day-to-day strain on your shoulder muscle.

Allow your affected arm to hang down and gently move in a circular motion. As you make progress in your recovery, feel free to gradually widen the circle or add a small dumbbell to your routine. It helps to put one hand on a table or hard surface while leaning over.

2. Fingertip walk

Start by facing a wall, standing about three-quarters of an arm’s length away. Starting at waist level, slowly walk your fingers up the wall until you’ve gone as high as your pain level will allow.

Your elbows should be slightly bent and your fingertips should be doing the work (not your shoulder).

3. Towel stretch

Hold each end of a hand towel behind your back in a horizontal position. Use your good arm to pull the affected arm upward, giving it a lengthening stretch.

If you feel like you need a deeper stretch, drape the towel over your good shoulder and use your affected arm to gently pull the towel down towards your lower back.

4. Chest opener

Stand with your affected shoulder near a wall, about one foot away. Place your hand against the wall at about chest level. Keeping the palm of your hand flat against the wall, slowly turn away from the wall as far as you can. When you reach that point, pause and take a deep breath before turning back towards the wall.

The following video shows how to do this and the previous two stretches.

5. Cross-body stretch

This particular stretch can be done sitting or standing. Simply take your affected arm and reach across the front of your body.

Use your unaffected hand to gently lift your arm at the elbow exerting gentle pressure.

6. Armpit stretch

Find a shelf or counter that is about chest-high. Lay both arms on the surface with your palms facing down. Slowly bend your knees to stretch the armpit area.

Try to increase your bend a little more each time.

7. Overhead stretch

First, lay flat on your back with your arms by your side. While taking a deep breath in, slowly lift your arms up over your head as far as you can.

Take a breath and slowly lower your arms back down. Gradually increase your stretch by reaching farther each time.

8. Outward rotation

Hold a rubber exercise band between your hands. Keep your elbows at a 90-degree angle and close to your sides. Gently rotate the lower part of your affected arm outward and hold it for five seconds.

Aim to rotate your arm about two to three inches.

9. Inward rotation

Using the same rubber exercise band, stand next to a closed door and put one end of the band around the door knob. Hold the other end of the band with the hand of your affected arm and gently pull the band toward your body about two to three inches.

Again, your arm should be at a 90-degree angle. Aim to hold this position for five seconds.

10. Puppy pose

If you’ve ever done yoga, puppy pose will be familiar to you. It’s really a cross between child’s pose and downward-facing dog.

Start on all fours with your shoulders above your wrists and your hips above your knees. Breathe while slowly walking your hands forward, keeping your hips above your knees. When you reach as far as you can go, release your chest or your chin to the ground. Hold for 30 seconds to one minute in order to let your spine and arms lengthen.

Other frozen shoulder treatments

If you’re interested in adding to your daily routine of exercises and self-massage, there are other non-invasive treatment options you can try. The following activities may help relieve pain associated with frozen shoulder:

• Yoga: Gentle exercise can increase your range of motion and help loosen scar tissue. Yoga is a great way to stretch, whether at home or in a group class. Be sure to modify when necessary to avoid further injury.
• Swimming: Water-based exercise or therapy is another beneficial activity if you are experiencing limited range of motion due to pain. Swimming and even gentle water aerobics are non-weight-bearing activities that can take pressure off your shoulder.
• Physical therapy: A physical therapist can help design an exercise plan to open up the shoulder joint. Exercises may be similar to the ones discussed here, but done in a controlled manner. A therapist is especially useful when you’re suffering from severe or chronic shoulder pain.
• Chiropractic care: Chiropractors use alignment techniques to ease the symptoms associated with frozen shoulder syndrome. In many cases, chiropractic care is a great way to prevent frozen shoulder before it happens, if you believe you may be at risk.

Interventional treatments

If you have a severe case of frozen shoulder, talk to your doctor about steroid injections. This type of injection can reduce inflammation and pain so that you can begin to exercise or undergo physical therapy to break up scar tissue.

When all other options have been unsuccessful, your doctor may recommend surgery. There are two main surgeries associated with frozen shoulder syndrome. Manipulation is when a doctor places you under anesthesia so that they can physically move the arm in the socket to break up scar tissue. Arthroscopic capsular release involves cutting through tight tendons and tissues to release what’s holding your shoulder.

Surgery is a last resort. The vast majority of patients will find relief using massages, stretches, or other complementary therapies.

Find help

If your shoulder pain persists day and night, interrupting your everyday activities, it’s probably time to talk to a doctor. If you’re in the Arizona area, our doctors at Arizona Pain can help you get on the road to recovery.

Our team consists of highly qualified chiropractors, pain specialists, and more. We strive to help our patients alleviate their pain, as well as provide solutions for future options.

If you’re ready to learn more about treatment options for your frozen shoulder pain, reach out to one of our pain specialists today.

Shoulder pain at night is a very common issue among chronic pain sufferers. The shoulder is one of the most vulnerable joints as it has such a wide range of motion, which opens it up to various injuries and problems. So, why are you experiencing shoulder pain at night and what can you do to find relief? We discuss five treatment options ranging from shoulder stretches to chiropractic to interventional procedures.

Issues associated with shoulder pain at night

On top of the pain, most people with shoulder pain at night sleep poorly, which has a completely different set of problems associated with it. These can include:

• Increased sensitivity to pain
• Low energy
• Mood disorders

Sleeplessness can become a vicious cycle of decreasing sleep and increased pain, which will only make your condition worse.

Causes of shoulder pain when night

Although many shoulder disorders can cause pain, the most common cause of shoulder pain at night comes from rotator cuff tendinitis. It usually is caused by irritation of the shoulder tendons leading to inflammation and pain. This condition can be caused by many things, including:

• Tears
• Poor posture
• Overexertion
• Repetitive work injuries
• Aging

Rotator cuff tendinitis is known to affect millions of people in the U.S. each year and is a major cause of shoulder pain when sleeping.

Some of the other causes of shoulder pain at night are:

• Osteoarthritis
• Frozen shoulder
• Shoulder dislocation

Why exactly does the pain increase at night even though it might be fine during the day?

Why do I have shoulder pain at night only? 

While this nighttime shoulder pain cannot always be explained, a lot of the pain comes down to:

• Being still at night
• Unrelieved tension and stress from the day
• The sleeping position you choose
• Your mattress

During the day, the shoulder is being actively used while you are in a vertical position. The tendons engage and are pulled downward by gravity, which allows space to be made in the muscle groups in the shoulder. This additional space allows for an increase in blood flow and oxygen that alleviates the stiffness and pain that would be present otherwise.

When you lay down to rest or sleep at night, you are generally in a horizontal position. This removes the effect of gravity and allows the shoulder muscles to relax. The lack of movement and the relaxation of the muscles allows the fluids in your joints to settle and decreases the flow of blood, allowing the joint to become inflamed. People also tend to lie on their shoulder while sleeping, which can compress the joint even further, and thereby worsening the inflammation.

How-to relieve shoulder pain at night

If your shoulder pain is worse at night, there are ways to ease your pain.

1. Find a better sleeping position 

The first course of action to relieve shoulder pain at night is to find a good sleeping position for you. Tossing and turning at night is normal for most people, but can agitate your shoulder if you land on it wrong. Sleeping on the opposite shoulder can help avoid this pain, but try not to sleep on your back.

If the pain persists, you can always trying wrapping your arm or wearing a sling to assist in preventing movement during sleep. Sleeping with a pillow under your knees can help alleviate any associated back pain.

2. Stick to a sleep schedule 

Along with fixing your position while sleeping, always make sure to try to stick to a sleeping schedule. Good sleep hygiene can make all the difference in your sleeping patterns. Having a consistent bedtime ritual that helps wind you down at the end of the day can do wonders in terms of reducing stress and tension, and improving sleep length and quality.

Try something relaxing before bed like a shower and make sure you fall asleep in a dark room with no electronics. Medication can also help you sleep, but be cautious of how often you use them. Constantly requiring sleep aids can be a major sign of a problem and the more you use over-the-counter drugs, the more you will need to be effective. In addition, if you’re using other medications, they may react poorly with the sleep aids.

3. Perform stretches for shoulder pain at night 

Exercising a few hours before bed can also be useful as it will increase blood flow throughout the whole body. This can alleviate pain, but also relax you enough to ease sleeping troubles. Try something low impact like a brisk walk or a bike ride, and then allow your body to cool down again before going to bed.

Further, certain shoulder stretches can help you reduce the tension and stress that has built up during the day. Not only are shoulder stretches an easy option, but they take only a few minutes at night. Stretching has huge health benefits like increasing flexibility, range of motion, and blood flow. Another big plus is that they are simple to do in your own home and require no special equipment. Before you go to bed, try these seven shoulder stretches to alleviate some tension and reduce your stress.

Shoulder stretch basics

If you start to feel pain at any time during a stretch, stop immediately. Stretching should be done to the point of mild strain. If you experience pain, you are going too hard and could injure yourself. This is especially true if the pain is sharp or sudden. It is a good idea for chronic pain sufferers to consult a pain doctor before starting too strenuous of a stretching routine as overexertion could exacerbate certain conditions.

For best results, always warm your muscles up a little before stretching. For the following stretches, it is best to do each for approximately 30 seconds to one minute for maximum effect. Also, make sure you are steadily breathing in and out in a controlled manner.

Chin retractions

This is a quick stretch that is great if you spend way too much time staring at a computer monitor. Slowly extend your neck outward, making sure your keep your chin parallel with the floor. Then, pull it back in to a neutral position that is straight with your spine, slightly tucking the chin in. Repeat.

Eagle arms

Sit in a cross-legged position on the ground. Extend your arms in front of you and place your left elbow in the crook of the right arm. Now, bend your elbows back so your hands are touching. Hook one hand over the other so that your palms are facing each other.

For this stretch, you should keep your palms together, elbows lifted in a 90 degree angle, and your hands in front of your face. Try to keep your shoulders relaxed and down. You should feel a powerful stretch in your shoulder blades as well as the lower part of your neck. After this, change arms by placing your right elbow in the crook of your left arm and repeating.

Cow-face pose

Take your right arm and reach over your shoulder aiming to lay your palm in-between your shoulder blades. Then take your left arm and reach up your back (not over the shoulder) also placing the hand between the shoulder blades. Try to interlock your hands and pull slightly.

If you are having trouble interlocking your hands, you can modify this stretch. Keep a towel or something similar in your top hand, and then grasp it with your bottom hand instead of clasping the hands together. Gently pull with each arm to feel your shoulders start to open up.

Standing wall stretch

While standing tall, reach out and place both of your hands on a wall. Walk your feet back until the arms are straight, but don’t let your arms reach too far above your head. Make sure you keep the shoulder blades open and relaxed downwards during the whole stretch. Also, avoid pushing against the wall and don’t allow your shoulders to press up and into your neck.

Shoulder blade stretch

Start by spreading your feet, so they are shoulder-width apart. Raise your arms above your head as far as possible and bring your palms together. Now, simply twist your waist by bringing one shoulder forward and simultaneously pulling the opposite shoulder back. Hold this stretch and then switch sides.

Half-dragon fly

This stretch begins by lying face down on your stomach. First, place your right hand palm down on the floor like you are starting a pushup. Next, lift your chest slightly and slide your left arm under your chest. Finally, square your chest with the floor and lower on top of your arm. Hold this position and then switch your arms.

If you want a deeper stretch in this position, you can move on to the full dragonfly. This is accomplished by lying on your stomach face-down. Crisscross both arms near the collar bones and straighten your arms out as far as possible. Then, allow your body to drape onto your arms.

Triangle

Stand your feet hip-width apart. Turn your right foot forward. Turn the left foot so it is perpendicular with the right and raise both arms to shoulder level straight out from the body.Stretch your right arm up and forward, pulling your body up slightly. Then slowly lower the chest forward over the right leg until it is parallel with the ground. Place your hand on your thigh or calf, while avoiding placing it on the knee directly. Try to keep as little weight in your hand as possible, focusing on keeping yourself upright with your core instead. Extend the left arm completely upward towards the ceiling, if it feels comfortable. Finally, turn your head upwards towards the ceiling or down towards the ground for an additional neck stretch.

4. Try yoga poses for neck pain

Since shoulder pain at night is often related to neck pain, trying the following yoga poses for neck pain could also help relieve your pain. This video also demonstrates the triangle shoulder stretch.

5. Talk to a pain doctor about interventional therapies 

If these natural treatments don’t work to relieve your shoulder pain at night, it may be time to talk to a pain doctor. They can help diagnose the exact cause of your shoulder pain. If your pain isn’t due to an acute injury or fracture, they may suggest interventional treatments for chronic pain.

These shoulder pain at night treatments include:

• Physical therapy to increase flexibility and reduce pressure on your joint
• Chiropractic care to increase mobility and loosen tension
• A regimen of non-steroidal anti-inflammatory medications
• Joint injections that can relieve nerve irritation
• Surgery, but only for the most severe cases of shoulder pain at night

If more conservative treatments like chiropractic care or physical therapy haven’t worked, a joint injection provides a minimally-invasive treatment that doesn’t require surgery. You can learn more about this approach in the following video (while not a shoulder injection, it does showcase a knee joint injection using a similar approach).

Signs to watch for

It’s always best to consult a medical professional before starting any kind of treatment for shoulder pain. A proper diagnosis is always critical, so you may need an examination and other tests, such as an MRI or X-ray.

Shoulder joint pain can come from many different causes, but they share many similar symptoms such as being tender or warm to the touch. You should always talk to your physician if you are experiencing:

• Excessive stiffness, pain, or swelling in your shoulders
• Difficulty moving your shoulder or performing daily activities due to pain

Some types of shoulder pain such as arthritis can cause permanent damage, which can be mitigated if caught early enough.

If you experience any of the following symptoms, reach out to your doctor immediately:

• You begin to experience a fever or chills
• If severe shoulder pain is constant for more than four days or intermittently for two weeks
• You start losing weight without reason
• You have excessive night sweats

It is important to have these symptoms checked as soon as possible as these can be symptoms of serious conditions that should be treated immediately.

Do you experience increased shoulder pain at night? If you’re ready to learn more about treatment options that could work for you, reach out to one of our pain specialists.

The shoulder joint allows us to do everything from hugging our children to putting groceries in the car. Rather than one joint working in isolation with limited movement, the shoulder enjoys a wide range of motion – the widest of any joint in the body. When shoulder pain strikes, we quickly understand how important (and well-used) the shoulder joint is. Shoulder bursitis is a common ailment for many people, with symptoms ranging from a minor inconvenience to completely debilitating pain. As with the condition itself, shoulder bursitis treatments may be minor (changes to your routine) to more involved (full-blown surgical intervention). Here are nine at-home and advanced interventional shoulder bursitis treatments to consider.

What is shoulder bursitis?

Shoulder bursitis is best understood in the context of shoulder anatomy. Three bones meet to make up the shoulder:

• The humerus (upper arm bone)
• The scapula (shoulder blade)
• The clavicle (collarbones)

The shoulder joint itself is a ball-and-socket joint that is part of the larger anatomy of what is known as the shoulder girdle (or shoulder capsule). This entire structure consists of four joints.

• The shoulder joint: Also called the glenohumeral joint, with a ball-and-socket movement where the humerus fits into the scapula
• The acromioclavicular (AC) joint: The point where the scapula meets the clavicle (this forms what is known as the “roof” of the shoulder)
• The sternoclavicular (SC) joint: The connection between the clavicle and the sternum
• The scapulothoracic joint: The attachment between the scapula and the ribs at the back

The rotator cuff is a group of muscles that surrounds the shoulders, giving it support and allowing it a free range of motion. Ligaments and tendons further stabilize all four joints, attaching muscle to bone (tendons) and bone to bone (ligaments). The cup-like glenohumeral joint receives the humerus and helps it to glide smoothly with a lining of cartilage. Further cushioning and easing your movements are small, fluid-filled sacs called bursa.

With so many moving parts, shoulder injuries and pain are one of the more common upper body pain conditions. Of these, shoulder bursitis, also called rotator cuff tendonitis or impingement syndrome, is arguably the most common. Shoulder bursitis occurs when the bursa become irritated and inflamed. Depending on the severity, this inflammation can completely shut down mobility in your shoulder.

What causes shoulder bursitis?

The most common cause of shoulder bursitis is any activity that involves repetitive motion, especially overhead. Baseball players, tennis pros, and golfers are frequently diagnosed with shoulder bursitis.

If your job requires kneeling or reaching overhead repeatedly (i.e., cleaning floors or hanging drywall), you are at a higher risk for shoulder bursitis as well. Leaning for long periods of time on the elbows can also irritate the bursa and lead to shoulder bursitis.

Finally, injury or trauma to the joint can cause shoulder bursitis. This includes car accidents, falls, or blows to the shoulder in contact sports. In some cases, shoulder bursitis develops some time after the injury occurs, perhaps in response to the healing process or as a result of restricted movement. This is not to be confused with frozen shoulder (a condition that affects the connective tissue in the shoulder, not the bursa.)

Shoulder bursitis can occur in anyone at any age but most commonly affects older adults. People with other health conditions like rheumatoid arthritis, gout, and diabetes are also more at risk.

Do I have shoulder bursitis?

Shoulder bursitis symptoms are typically worse at night after a long day of activity, or in the morning when the shoulder has been still for a long period of time. The most common area for shoulder bursitis is the subacromial bursa. Inflammation in this area causes pain when the arms lift overhead.

Other shoulder bursitis symptoms include:

• Range of motion that is restricted by pain
• Swelling and redness in and around the shoulder joint
• Pain at the tip of the shoulder
• Pain upon contact

In severe cases, pain may be accompanied by fever, which may indicate an infection of the bursa. Infection can become serious and should be treated urgently.

Your doctor will start your shoulder bursitis diagnosis by asking about your medical history and conducting a physical exam. Your doctor will test your range of motion and feel for swelling or warmth that indicates inflammation in the joint.

If, other than pain, there are no other physical symptoms, your doctor may recommend imaging to rule out other causes. X-rays cannot detect inflamed bursa but can verify that there is no damage in the bones. MRIs can see soft and connective tissue and may be able to help with a diagnosis.

In cases where they suspect an infection, your doctor may order blood tests to look for elevated white blood cells that indicate an immune response to infection. If there is fluid on the shoulder, this fluid can also be analyzed to confirm a diagnosis (or rule out other conditions).

Will shoulder bursitis go away on its own?

If nothing changes, shoulder bursitis will, at best, stay the same. When the bursa are inflamed and irritated, continuing with the same activity usually makes the problem worse. This does not mean all movement needs to stop. There are a variety of shoulder bursitis treatments at home and shoulder bursitis exercises that can help ease symptoms and treat pain and inflammation. These are best done after a diagnosis, though, and under the guidance of your doctor.

Regardless of treatment, shoulder bursitis recovery time will vary depending on the severity of your symptoms and any underlying health conditions.

How to treat shoulder bursitis: 9 treatments

At-home shoulder bursitis treatments are often adequate to treat shoulder bursitis symptoms and heal your pain and inflammation. The following five at-home treatments are a great place to start to ease pain while keeping a good range of motion. More interventional techniques are discussed after.

1. Rest

In the acute phase, you should rest your shoulder. This means limiting the activity that lead to the inflammation. Restricting extreme overhead motion (e.g., playing tennis or any activity that has your arms raised overhead) for a few days can give the inflammation a chance to recede.

In some cases, immobilizing the arm completely with a sling may be necessary. Typically, you’ll combine rest with other at-home shoulder bursitis treatments.

2. Ice

Also in the acute phase, ice can help calm inflammation and offer acute pain relief.

Applying ice packs in a 20-minute on, 20-minute off schedule for the first 24 hours may also provide significant (if chilly!) pain relief.

3. Warmth

After the first 24 hours, warming pads and hot baths can help keep blood flowing in the shoulder capsule and also provide significant pain relief.

4. Medications

The best medications for shoulder bursitis are usually over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. These control both pain and inflammation. Even though they are sold over the counter, it is important to take them only as directed.

If an infection is suspected, your doctor may also prescribe antibiotics. Take these as directed as well, making sure to finish the entire course (even when your shoulder begins to feel better).

5. Shoulder bursitis stretches

Once the inflammation and pain subsides somewhat, shoulder bursitis stretches can help restore (and increase) your range of motion for better shoulder health. These are low-impact stretches that can be done every day. You may want to complete these shoulder bursitis exercises for both shoulders to stay balanced in your range of motion. Note: only perform these stretches after getting approval from your doctor.

Shoulder circles

Stand (or sit in a chair with both feet flat on the ground). On an inhale, lift both shoulders towards your ears and pause at the top of the inhale. Exhale and circle your shoulders back and down, feeling the shoulder blades come together on your back. Repeat five to ten times daily.

Hand presses

Stand with your injured shoulder next to the wall. Bend your elbow at a 90-degree angle. Press the back of the hand against the wall and hold for five seconds. Repeat five to 15 times daily.

Strap stretches

Take a strap or a belt between your hands, wider than your shoulders and with your palms facing down. On an inhale, keep your arms straight but raise your arms above your head. Hold for five seconds, then slowly lower. Repeat five to ten times. As your shoulder heals, you can exhale and lower the arms behind the body (making them as wide as needed to keep the arms straight), then inhale to bring them back up and overhead to the front.

Shoulder opener

Stand facing a wall (the front of your body should be touching the wall). Raise the arm with the injured shoulder with the elbow bent at a 90-degree angle and place it on the wall (palm facing the wall). Slowly begin to turn your body so that the raised arm is flat on the wall, but your body is opening away from the wall. Stop when you feel a good stretch then breathe there for ten breaths. Stretch the other shoulder the same way, then repeat two more times on each side.

Whichever stretches you complete, take your time and be patient with your healing. Moving too quickly or ignoring extreme pain can only prolong the healing process or exacerbate your shoulder bursitis, so proceed with caution.

6. Physical therapy

The best shoulder bursitis treatment approaches combine at-home treatments with further intervention when needed. Here’s what you can expect.

A physical therapist can work with you to correct any underlying mechanical issues that may have caused your inflammation.

This means working to strengthen the muscles that support the shoulder while adding range of motion exercises and proper alignment techniques to support the shoulder and prevent further injury.

7. Chiropractic care

Chiropractic care uses spinal manipulations to safely realign the spine.

This may help address any issues in the shoulder that are caused by misalignment of the vertebrae anywhere along the spine, but especially in the upper portions.

8. Acupuncture

Acupuncture uses the principles of traditional Chinese medicine to clear up blocked channels in the energy meridians of the body.

During this procedure, hair-thin needles are inserted at specific points in the body depending on what condition is being treated. Initial studies show clinically significant decreases in shoulder pain when compared to sham acupuncture treatments.

9. Interventional treatments and surgery

In some cases, joint injections to relieve pain and inflammation may be recommended, but this is not considered a first-line treatment and is generally only utilized when conservative measures have failed. However, for those who are experiencing severe or chronic pain, shoulder injections can help manage their pain while undergoing other treatments like physical therapy.

For extreme and chronic shoulder bursitis that does not resolve after six months of treatment, surgery to drain the bursa (or remove them altogether) may be explored.

If you are looking for shoulder bursitis treatments in Arizona, give the pain specialists at Arizona Pain a call. We can design a personalized treatment plan that will get you back to doing the things you love!

Reaching for a plate from the cupboard is something you probably don’t think twice about. As healthy and active adults, these everyday tasks are seemingly effortless. Unfortunately, for patients with intense shoulder pain, even basic movement can feel impossible. Frozen shoulder syndrome is one of the many conditions responsible for nagging aches, pains, and tightness in this ball-and-socket joint. If you’re suffering from an unknown cause of shoulder pain and tightness, here’s what you need to know about frozen shoulder symptoms.

What is frozen shoulder syndrome?

Frozen shoulder syndrome, also known as adhesive capsulitis, is a condition that can create stiffness and pain in your shoulder. Your shoulder joint is encased in connective tissue that can thicken and tighten around the joint, resulting in discomfort.

While the cause isn’t completely understood, doctors agree that it is commonly seen in people who have had to immobilize their shoulder for a long period of time. This leads to the original onset of pain, which eventually turns into excessive stiffness. As a result, your range of motion in the shoulder joint can become so limited that it feels as if your shoulder is frozen in place.

In extreme cases, patients can’t move their shoulder at all. As time goes on, this lack of movement allows scar tissue to build up, further restricting range of motion.

What are the first signs of frozen shoulder?

Frozen shoulder syndrome occurs gradually over a long period of time.

You will likely first become aware of dull and aching pain. It is usually located over the outer shoulder area and sometimes the upper arm. As the pain intensifies, you may be unknowingly moving your shoulder less and less. You may eventually find that you can’t move your shoulder as you once did. When the pain is severe enough, you may not be able to do anything that involves shoulder movement.

There are some people who are at an increased risk for developing frozen shoulder syndrome. In general, it is most common in patients between the ages of 40 and 60, and occurs in women more often than men.

If you stop using your shoulder due to pain or injury, it will naturally become stiff. This is why patients recovering from medical conditions or procedures that prevent arm movement are at a greater risk. Some of these include those with:

• Requirements to wear a shoulder sling after a surgery, stroke, or injury
• Diabetes
• Thyroid disorders
• Cardiovascular disease
• Tuberculosis
• Parkinson’s disease

What are common frozen shoulder stages?

There are three common stages of frozen shoulder syndrome. Each has unique symptoms, as well as a timeline. These are some of the early and advanced signs of each.

Freezing stage

In the initial stage, also known as the freezing stage, pain develops in your shoulder any time you move it. As a result, you may stop moving your shoulder as much.

Unfortunately, this only makes the problem worse. The less you move, the more scar tissue will continue to form. The pain during this stage can be severe and will usually increase over time, lasting anywhere from six weeks to nine months.

Frozen stage

While the frozen stage can often bring pain relief, it may also mean increased stiffness.

Moving your shoulder will become even more difficult as range of motion diminishes or disappears completely. This stage will typically last anywhere from four weeks to six months.

Thawing stage

The thawing stage lasts anywhere from six months to two years as your range of motion starts to improve.

For some, it can eventually return to how it once was. Your pain level may decrease substantially or even completely disappear once inflammation is under control.

The most common frozen shoulder symptoms

The 5 most common symptoms of frozen shoulder syndrome include the following:

1. Shoulder pain
2. Associated neck pain
3. Stiffness
4. Mobility issues
5. Increased pain at night

Let’s take a closer look at each symptom.

1. Shoulder pain

The most obvious and clear sign of frozen shoulder syndrome is pain, particularly in the musculoskeletal tissues and nerves in the shoulder area. This region includes the clavicle, upper humerus, and scapula.

While the pain may start out as dull, it will typically increase over time. The first stage of frozen shoulder syndrome comes with the highest pain levels. This phase can last anywhere from six weeks to nine months.

2. Associated neck pain

Because they’re so closely connected, neck pain often comes with shoulder pain.

The connective tissue that tightens and thickens leading to frozen shoulder also includes the tissue that connects your shoulder to your neck. Because the pain causes most patients to limit movement, this can further aggravate the issue.

3. Stiffness

While the second stage of frozen shoulder syndrome comes with decreased pain levels, this is when stiffness comes in. This is the stage that gives frozen shoulder syndrome its name.

The frozen feeling makes moving incredibly difficult, and in some cases, completely impossible. This is because the capsule of connective tissue becomes so tight and thick around the shoulder joint that it seems to freeze the shoulder in place.

4. Mobility issues

Patients suffering with frozen shoulder syndrome experience pain that intensifies over time. Suddenly, getting dressed or lifting your arm to reach for something becomes excruciating.

It’s a vicious cycle. This restriction naturally causes most patients to minimize shoulder movement, which only worsens the condition. Scar tissue may begin to develop in the shoulder, effectively “freezing” the shoulder in place.

5. Increased pain at night

In some patients, pain seems to increase during sleep.

When you lay down, the effect of gravity is removed, which allows the shoulder muscles to relax. The lack of movement paired with relaxation of the muscles causes the fluids in your joints to settle. This decreases the flow of blood, allowing the joint to become inflamed.

People also tend to lie on their shoulder while sleeping, which can compress the joint and worsen inflammation.

It is also possible that the lack of distractions at night makes certain patients more aware of their pain while they’re trying to sleep.

How to diagnose frozen shoulder syndrome

If you believe you may be experiencing frozen shoulder syndrome symptoms, you should visit your doctor for a physical exam. There is no definitive test that can diagnose this condition. Instead, your doctor will observe your range of motion, while also taking into account your medical history.

Your doctor will ask you to move in certain ways and assume different positions to check for what prompts your shoulder pain. Your doctor will also evaluate both active and passive range of motions. Active range of motion involves movement that you control. Passive range of motion is when you’re asked to relax your muscles and your doctor moves your arm for you. Both are important in determining whether you are suffering from frozen shoulder.

In some cases, you will receive a numbing injection to make this type of evaluation possible. This is usually done if your pain is so unbearable that it is too difficult to test movement capability.

Imaging tests, such as X-rays, magnetic resonance imaging (MRI), and ultrasound can also be used. They can’t diagnose frozen shoulder syndrome, rather they typically rule out other conditions or injuries that could be causing your pain. If your doctor can confidently say you’re not dealing with another condition, such as arthritis or a torn rotator cuff, it is more likely that you are dealing with frozen shoulder syndrome.

How do you get rid of a frozen shoulder?

A frozen shoulder will typically resolve itself, but this can take anywhere from nine months to years. In the meantime, many patients seek ways to speed up the recovery process. This can reduce the daily struggle of dealing with pain and limited mobility.

Treatment options for frozen shoulder syndrome vary greatly. From natural at-home remedies to interventional methods, there are several approaches your doctor may recommend. Find what works in your particular case. Your doctor will encourage you to attempt as many non-invasive methods as you can before moving on to more interventional approaches.

At-home frozen shoulder treatments

Always talk to your doctor before attempting any treatments. Once approved, at-home treatments may include stretching, exercise, and hot and cold therapy.

By keeping your shoulder healthy and mobile with stretching and exercise, you may be able to alleviate some of your pain and greatly reduce the stiffness you experience. As long as you listen to your body and move slowly, exercises like diagonal shoulder openers and fingertip walks can keep your case of frozen shoulder mild.

Alternating between hot and cold therapy can also reduce shoulder pain significantly. Using a heating pad can reduce stiffness and increase blood circulation. Alternatively, cold therapy is best for reducing acute inflammation that causes pain around the shoulder joint as you ready for another round of stretches.

Complementary and interventional therapies

If you’ve tried at-home approaches with no pain relief, your doctor may recommend a combination of the following treatments:

• Physical therapy: If you’re concerned about working through exercises and stretches on your own, a qualified physical therapist can help. Physical therapists are there to safely and gradually increase the intensity of your regimen for optimal healing. They can also offer guidance on balancing exercises on both sides of the body. This will help you avoid compensating in ways that cause injury to other parts of the body.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Over-the-counter pain relievers such as aspirin and ibuprofen can provide short-term pain relief. This is helpful because it reduces inflammation, enabling you to move freely without pain. As previously mentioned, the more you can keep moving, the better off your shoulder will be. Work with your doctor to determine which medication is best for your specific case.
• Steroid injections: Corticosteroid injections can reduce inflammation and pain to improve mobility. They typically provide relief for several weeks or months, which can help you stay mobile and stick to a physical therapy routine. Consistent exercise can aid in breaking up scar tissue to reduce the stiffness of frozen shoulder syndrome.
• Surgery: In extreme cases, and when no other treatment options have worked, your doctor may recommend surgery. This typically involves an outpatient procedure to remove scar tissue from inside your shoulder joint. Stitches are removed after ten days and postoperative physical therapy is usually necessary. Many patients report having their full range of motion restored after a few months.

How to prevent frozen shoulder

If you’ve recently found relief from frozen shoulder syndrome, you may be afraid of a recurrence. You’ll find comfort in knowing that frozen shoulder rarely develops again in the same shoulder. However, some people do experience it in the opposite shoulder. Fortunately, there are things you can do to prevent this.

One of the most common contributors to frozen shoulder syndrome is a lack of mobility. This may occur while you’re recovering from surgery or an injury, or perhaps you’ve suffered a heart attack or stroke. Whatever the case, it’s important to keep your body moving as much as possible, and under the care of your medical team.

Your doctor may recommend exercises, stretches, and other conditioning techniques to keep your shoulder strong while you are recovering. This can maintain your range of motion and prevent the buildup of scar tissue that could lead to another bout of frozen shoulder syndrome.

Working with a physical therapist can be helpful if you’re concerned about maintaining a healthy exercise regimen that is still within your comfort level.

Do you believe you may be suffering from frozen shoulder symptoms? Contact our pain specialists at Arizona Pain. Our team will help you find the right treatment options for your shoulder pain.