Published: April 30, 2007
Frozen shoulder is a common cause of shoulder pain. But is it related to cold weather or to cold exposure? Could the cause of your shoulder pain really relate to the outer temperature of your shoulder joint?
Frozen shoulder is also known as adhesive capsulitis and the two terms are used almost interchangeably. The use of the word adhesive relates to the fact that the joint surfaces inside the painful shoulder become sticky because of inflammation in the joint.
Doctor’s first recognized adhesive capsulitis in the late 1800’s when they realized that it was a different condition from arthritis of the shoulder. Frozen shoulder is not a form of arthritis and it does not develop into arthritis – this is worth remembering because many patients do worry that their shoulder pain will lead on to arthritis.
The shoulder pain from frozen shoulder can start quite quickly after an injury or it may sometimes develop more gradually without any obvious trigger. But where does the word frozen fit into the shoulder pain picture?
A frozen shoulder can cause severe shoulder pain and may produce pain that spreads down the arm from the shoulder towards the elbow or the wrist. Women with frozen shoulder find it very difficult to unfasten their bra because they cannot get their hand around behind their back. Men can’t reach the back pocket of their trousers because their range of shoulder movement is limited.
One of the first textbooks to devote attention to adhesive capsulitis was published in the 1930’s and it only devoted a few pages to the subject of frozen shoulder. The author said that frozen shoulder pain was common, but little was known about the cause or the problem inside the joint. Things have changed a lot in medicine since 1930 but doctor’s still don’t have a clear answer to the question of what triggers the process that leads to a frozen shoulder.
About twenty years after this textbook was written a surgeon tried to perform surgical operations on the shoulders of patients who were suffering from frozen shoulder pain. During his attempts he found that the gristly capsule around the joint was stuck to the bone surface. He had to peel it away like a Band-Aid or elastoplasts strip. Because of this he coined the name Adhesive Capsulitis. The terms frozen shoulder and adhesive capsulitis have been used interchangeably ever since.
So why does a frozen shoulder get stiff? Will exposure to cold nighttime air bring on the stiffness and the shoulder pain?
Inflammation anywhere in the body causes stickiness. The cells that control the inflammation process trigger a reaction in the tissues of the body and tend to cause adjacent bits to stick to each other – not usually on a permanent basis but certainly for some weeks or months.
Now – a capsule of gristle surrounds the shoulder joint and the capsule has a little flap or bag that hangs down into the armpit. If this little bag fills up with sticky fluid then the sides of it will stick together – making it very difficult to lift your arm above your head.
If the front of the capsule sticks itself to the bone of the upper arm then you’ll find it nearly impossible to rotate your arm properly – especially if you are trying to reach round into your back pocket, or to fasten your bra if you’re a woman.
Add some general sticking of the area around the shoulder muscles and tendons and you can surely now see why the shoulder seems to freeze up and stiffen. It’s quite literally stuck with a kind of natural glue! Adhesive Capsulitis indeed.
The end result of the frozen shoulder process is that the capsule around the joint shrinks or contracts and stays tight and stiff for many, many months before it gradually recovers.
So – does cold exposure really leave you with a sticky frozen shoulder? No, it doesn’t but there’s a lot still to be discovered about this unusual condition. If you have it then don’t panic – the pain will eventually resolve. In the meantime you can read more about frozen shoulder pain and frozen shoulder treatments on my website, where you’ll also find useful information about other joint and muscle pain conditions.
Dr Cameron has also created an electronic book on the subject of frozen shoulder. You can explore it and download a copy on his website.
Dr Gordon Cameron is a specialist in joint pain based in Edinburgh, Scotland. He is an expert in joint pain, lower back pain and in whiplash injury
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