In short…

Distinct conditions, distinct treatments. Frozen shoulder and shoulder impingement cause similar pain but require different diagnostic and treatment approaches.
Diagnosis is crucial. Accurate professional diagnosis is essential to determine the specific condition and ensure effective treatment.
Consult a healthcare professional for personalized guidance and treatment if you experience persistent shoulder pain or limited mobility.

Frozen shoulder and shoulder impingement are distinct but sometimes overlapping conditions affecting the shoulder joint. Both can significantly impact daily life, making accurate diagnosis and appropriate treatment crucial for restoring function and reducing pain.

This detailed guide will help you understand the differences between these conditions and the available treatment options.

What is Frozen Shoulder?

Frozen shoulder, medically known as adhesive capsulitis, is characterized by inflammation and thickening of the shoulder joint capsule — the connective tissue surrounding the shoulder joint. This thickening restricts movement, leading to progressive stiffness, pain, and significant limitations in range of motion. The condition typically develops slowly, progressing through freezing, frozen, and thawing stages, and can last for months or even years.

According to the National Institutes of Health, up to 5 percent of the general population experiences frozen shoulder at some point in their life, but typically start feeling symptoms around 55 years old.

Frozen Shoulder Symptoms and Stages

Frozen shoulder typically progresses through three distinct stages:

Freezing Stage:This initial stage is marked by increasing pain, particularly with movement. The pain often worsens at night and begins to limit the shoulder’s range of motion.
Frozen Stage:In this stage, pain may decrease slightly, but stiffness becomes more prominent, making daily activities involving shoulder movement increasingly difficult. The limited range of motion is the hallmark of this stage.
Thawing Stage:The final stage involves a gradual return of motion and a decrease in stiffness. Full recovery can take time, and some individuals may experience residual stiffness.

Frozen Shoulder Medical Treatment Options

Frozen shoulder medical treatment aims to manage pain and restore mobility. The specific approach depends on the stage and severity of the condition. Frozen shoulder medical treatment options include:

Physical therapy:This is a cornerstone of frozen shoulder treatment. Targeted exercises improve range of motion, stretch the joint capsule, and strengthen supporting muscles. A physical therapist can create a personalized exercise program to address specific limitations.
Medications:Over-the-counter pain relievers, such as ibuprofen or naproxen, can help manage pain and reduce inflammation. In some cases, stronger prescription pain medications may be necessary.
Steroid injections:Injecting corticosteroids directly into the shoulder joint can reduce inflammation and pain, particularly during the freezing stage, which can facilitate participation in physical therapy.
Hydrodilatation:This procedure involves injecting sterile fluid into the joint capsule to stretch the tissue and improve the range of motion. It is often combined with physical therapy for optimal results.
Surgical intervention:In rare cases when other treatments are unsuccessful, surgery may be necessary to release the tightened joint capsule. This is typically a minimally invasive arthroscopic procedure.

What is Shoulder Impingement?

Shoulder impingement, also known as subacromial impingement, occurs when the tendons of the rotator cuff muscles become compressed beneath the acromion (a bony projection of the shoulder blade). This compression leads to pain, weakness, and limited movement, particularly when raising the arm overhead.

Repetitive overhead movements, common in sports like swimming, tennis, and baseball, or occupations involving overhead reaching, can cause or exacerbate shoulder impingement. In fact, the Cleveland Clinic finds that shoulder impingement is almost always a result of an overuse injury.

Shoulder Impingement Symptoms

The primary symptom of shoulder impingement is pain, often described as a dull ache or sharp pain, that worsens with overhead activities. Other symptoms include:

Pain radiating down the side of the arm.
Weakness in the shoulder.
Stiffness and limited range of motion.
A catching or grinding sensation when moving the shoulder.
Pain at night, especially when lying on the affected side.

Shoulder Impingement Treatment

Most cases of shoulder impingement respond well to conservative treatments. The goal is to reduce inflammation, relieve pain, and restore normal shoulder function.

Rest:Avoiding activities that aggravate the pain allows the inflamed tendons to heal. This may involve modifying work tasks or temporarily stopping certain sports or activities.
Ice:Applying ice packs to the affected area for 15–20 minutes at a time, several times a day, can help reduce pain and swelling.
Physical therapy:A focused exercise program is crucial for strengthening the rotator cuff muscles, improving flexibility, and restoring normal shoulder mechanics. A physical therapist will guide you through specific exercises tailored to your needs.
Medications:Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help manage pain and inflammation. Your doctor may also recommend other pain relievers.
Steroid injections:In some cases, corticosteroid injections into the subacromial space can help reduce inflammation and pain. This is typically not a first-line treatment but can be helpful when other conservative measures fail.
Surgery:If conservative treatments fail to provide relief after several months, surgery may be necessary to decompress the impinged tendons. This is usually done arthroscopically, a minimally invasive procedure.

Key Differences in Symptoms: Frozen Shoulder vs. Impingement

While both frozen shoulder and shoulder impingement cause pain and stiffness, there are key differences.

Frozen shoulder typically involves a gradual loss of range of motion in all directions, making it difficult to perform even simple tasks like reaching behind your back, fastening a bra, or combing hair. The stiffness is persistent, regardless of activity.
Impingement pain, on the other hand, is often worse with specific movements, especially overhead activities, and may be accompanied by a catching or grinding sensation. The stiffness is often related to the specific movement causing the impingement.

Diagnosing Frozen Shoulder vs. Shoulder Impingement

Proper diagnosis is crucial for effective treatment.

A healthcare professional will conduct a thorough physical exam, evaluating your range of motion, pain levels, and shoulder stability. They may also order imaging tests, such as X-rays or MRI scans, to rule out other conditions or confirm the diagnosis.

Your medical history and description of symptoms also play a vital role in the diagnostic process.

Treatment Options for Frozen Shoulder and Shoulder Impingement

Physical therapy plays a vital role in treating both frozen shoulder and shoulder impingement. A skilled physical therapist can develop a personalized program to restore strength, flexibility, and range of motion, tailored to the specific condition and individual needs. This may involve manual therapy techniques, therapeutic exercises, and modalities like ultrasound or electrical stimulation to reduce pain and inflammation.

It’s essential to work with a healthcare professional to determine the right course of treatment depending on the underlying condition. Early intervention and accurate diagnosis are crucial for optimal recovery and long-term shoulder health.

At Greater Chesapeake Hand to Shoulder, we offer comprehensive evaluation and treatment options for both frozen shoulder and shoulder impingement.

Get the Right Frozen Shoulder Medical Treatment in Maryland Today

Accurate diagnosis is crucial for effective treatment. If you are experiencing shoulder pain or stiffness, don’t hesitate to seek professional medical advice.

Greater Chesapeake Hand to Shoulder is your premier center for shoulder-related orthopedic care. Our team of experienced orthopedic physicians and medical providers is dedicated to providing individualized care and helping you regain pain-free shoulder function.

Get the right or shoulder impingement or frozen shoulder medical treatment in Lutherville, Bel Air, Clarksville, Pasadena, and Westminster. Call Greater Chesapeake Hand to Shoulder today at (410) 296-6232 or use our online appointment request form.