Frozen Shoulder and Type 2 Diabetes
Last updated: May 2023
Frozen shoulder (also called adhesive capsulitis) causes pain and stiffness at the shoulder joint. Type 2 diabetes may increase your risk of frozen shoulder.1-3
What is frozen shoulder?
Frozen shoulder is caused by changes in the tissue that connects and surrounds the structures of the shoulder joint. This connective tissue is called the shoulder capsule. In frozen shoulder, the shoulder capsule becomes inflamed. This inflammation causes pain. Over time, the shoulder capsule thickens and limits shoulder movement.3,4
How much you can move your arm at the shoulder is called range of motion (ROM). Pain and reduced ROM from frozen shoulder often develop gradually. The severity of these symptoms varies from person to person. Frozen shoulder can limit your ability to do normal daily activities.2,4
Who can get frozen shoulder?
Most people who develop frozen shoulder are between 50 and 60 years old. Women are slightly more likely to have the condition than men.2-4
Risk factors for frozen shoulder include:2-4
- Thyroid problems
- Heart disease
- Other muscle and bone (musculoskeletal) problems
Frozen shoulder and diabetes
People with diabetes are up to 5 times more likely to develop frozen shoulder than those without diabetes. Experts believe high blood sugar and inflammation are related to this increased risk. But more research is needed to fully understand why diabetes may increase the risk of frozen shoulder.1,2
Studies suggest that people with diabetes have more pain and stiffness from frozen shoulder than those without diabetes. Frozen shoulder may also last longer for people with diabetes.1,3
The stages of frozen shoulder
Frozen shoulder often develops over weeks or months. Symptoms tend to progress through the following stages:3-5
- Phase 1: Freezing stage – Pain develops and gets worse as the shoulder ROM decreases. This stage can last 6 weeks to 9 months.
- Phase 2: Frozen stage – Worsening limitation in shoulder movement interferes with normal function. Pain may slowly improve. This stage can last 4 to 12 months.
- Phase 3: Thawing stage – Shoulder ROM slowly starts to improve. It can take 12 months to 2 years for normal shoulder function to return.
How is frozen shoulder diagnosed?
Frozen shoulder is typically diagnosed by a doctor who specializes in problems of the bones and joints (orthopedic doctor). The doctor will ask about your symptoms and medical history. They will also do a physical exam to test your shoulder movement. Frozen shoulder will cause limited movement when moving your arm on your own (active ROM) and when the doctor moves your arm (passive ROM).3
Imaging tests such as X-ray, magnetic resonance imaging (MRI), and ultrasound may be used to look at the shoulder structures. Frozen shoulder does not cause visible changes on these imaging tests. But these tests may be used to rule out other conditions such as arthritis or a torn rotator cuff.4
Blood tests do not show specific changes in frozen shoulder but may be used to rule out other conditions.4
How is frozen shoulder treated?
Treatment for frozen shoulder is focused on reducing pain and restoring normal shoulder movement. Common treatment options include:3,4
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – Over-the-counter (OTC) drugs like aspirin, ibuprofen, and naproxen may be used to relieve pain.
- Physical therapy – Gentle ROM exercises and stretching may help improve shoulder function.
- Oral steroids – These drugs may be used for a short time to reduce pain and inflammation.
- Joint injections – A steroid called cortisone is sometimes injected into the shoulder joint to help reduce inflammation. Another procedure, called hydrodilatation, involves injecting fluid into the joint to relieve tightening of the shoulder capsule.
- Surgery – If other treatments do not relieve your symptoms, your doctor may recommend surgery to release the stiffened shoulder capsule.
Long-term outcomes of frozen shoulder
Your doctor may give you gentle exercises to help keep the shoulder joint loose. For most people, frozen shoulder resolves within 18 to 30 months. But people with diabetes may take longer to recover. If you have pain and stiffness in your shoulder that prevents you from doing things you enjoy, talk to your doctor about your treatment options.3,4
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