When it comes to shoulder pain, people might expect problems to arise from an injury or a chronic issue with the joint. What they might not expect is a traumatic shoulder pain that happens spontaneously.
“Frozen shoulder is an entity that is unknown in its cause,” explained Dr. Eric Erickson, an Orthopedic Surgeon with ThedaCare Orthopedic Care. “It is quite strange that in 2022, we still can’t tell you why it occurs.”
When frozen shoulder happens, the lining of the joint, which is called the “capsule,” becomes inflamed and contracted, causing pain and loss of motion and pliability, Dr. Erickson said. This insidious problem progresses over time, causing ongoing discomfort including difficulty lying in bed at night. The loss of motion can lead to a high level of dysfunction for those who suffer from frozen shoulder.
“Then, at times, it will spontaneously ‘thaw out,’ where the pain decreases and the motion improves,” he said. “The difficult thing is that entire process can sometimes take 18 months to two years.”
While the cause is unknown, it most commonly impacts people in middle age, usually to the non-dominant arm, and people with diabetes are at a much higher risk of developing frozen shoulder, Dr. Erickson said.
“In people with diabetes, there are times where frozen shoulder will affect both shoulders, which is consequential,” he said.
For those patients whose symptoms improve without care, a significant number might experience some permanent loss of range of motion and can benefit from medical assistance.
“Here’s the reality: Most people aren’t going to tolerate frozen shoulder for 18 months to two years because their quality of life is so affected,” Dr. Erickson said. “Tolerating that impact to activities and to sleep is just a hard thing to do.”
The good news is there are treatment options available to patients. Providers at ThedaCare Medical Center-Orthopedic, Spine and Pain offer all necessary care under one roof, including physical therapy, which can restore a patient’s range of motion progressively. Oral anti-inflammatories can decrease pain symptoms, as can an ultrasound-guided injection of cortisone.
“If you are trying to stretch a frozen shoulder, you’re stretching very inflamed tissue, and it can be quite painful,” Dr. Erickson said. “Many people will benefit initially from an injection of cortisone to really calm that severely inflamed shoulder, and that can then make the therapy afterwards much more effective and tolerable.”
Most people will improve after a cortisone injection and therapy, but it likely will not be resolved overnight. It takes time.
At ThedaCare Medical Center-Orthopedic, Spine and Pain, Dr. Erickson sees patients every week who are suffering from frozen shoulder. Once that diagnosis is made, he can collaborate with other providers and refer his patients for needed care.
“It’s very common for me to arrange for them right at that moment to have them see one of our primary care sports medicine doctors that will do an ultrasound guided cortisone injection,” he explained.
Patients are scheduled to work with therapists at the physical therapy gym within the same building after a few days, once the cortisone takes hold.
“Their therapy can be more valuable as far as less pain, so they can make greater gains in a quicker period of time,” Dr. Erickson said.
For the very small percentage of patients whose pain and lack of motion remains unresolved by cortisone and physical therapy, there are surgical options available, again in the same building.
“The surgery itself is pretty simplistic, in the sense it’s an arthroscopic procedure,” Dr. Erickson said. “During the surgery, the tight tissue is released and the joint is re-expanded. The patient would then work with physical therapists to maintain that restored motion. It can be a frustrating diagnosis for people because it’s a journey and a process to get the motion back. If you remain dedicated to the therapy program, the overwhelming majority of people get through it without needing surgery.”
ThedaCare Medical Center-Orthopedic, Spine and Pain opened in July 2022 and offers expert care and the latest tools and technologies to help patients get back to a pain-free life. Surgery, physical therapy, acute care and other services are all available at the facility.
For more than 110 years, ThedaCare® has been committed to improving the health and well-being of the communities it serves in Northeast and Central Wisconsin. The organization delivers care to more than 600,000 residents in 17 counties and employs approximately 7,000 health care professionals. ThedaCare has 180 points of care, including eight hospitals. As an organization committed to being a leader in Population Health, team members are dedicated to empowering people to live their unique, best lives. ThedaCare also partners with communities to understand needs, finding solutions together, and encouraging health awareness and action. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a not-for-profit health system with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs, as well as primary care.
For more information, visit thedacare.org or follow ThedaCare on social media. Members of the media should call Cassandra Wallace, Public and Media Relations Consultant at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the marketing person on call.