Frozen shoulder is one of those things you’ve heard of but never think about until it actually happens. Unfortunately, people with diabetes are not uncommon, with some estimates suggesting that 10 to 30 percent of people have diabetes, compared to 2 to 10 percent of the general population.
This article explains how to diagnose, prevent, and treat frozen shoulder, as well as what to avoid if you have frozen shoulder.
What is frozen shoulder?
Frozen shoulder, also known as “adhesive capsulitis,” gradually progresses as the shoulder joint becomes stiff, eventually resulting in “frozen shoulder.”
This makes it difficult to raise the arm above the head or even at shoulder level, and any movement can cause significant pain. Over time, basic tasks like dressing and showering can become difficult.
Although the exact relationship between diabetes and frozen shoulder is not fully understood, research suggests that high blood sugar levels lead to the formation of AGEs (advanced glycation end products), which stiffen tendons and ligaments.
This, combined with impaired circulation, can lead to inflammation and inability to move. People between the ages of 40 and 60, especially women, are at increased risk, especially if they have had diabetes for many years.
How to diagnose frozen shoulder
This condition is usually diagnosed based on signs and symptoms.
Your doctor will test both your active range of motion (where you move your shoulder) and your passive range of motion (where your doctor moves your shoulder on your behalf). In both cases, restriction of movement often confirms the diagnosis.
How to prevent frozen shoulder
Unfortunately, there is no surefire way to prevent adhesive capsulitis.
However, controlling blood sugar levels can reduce the production of AGEs, which cause joint stiffness and inflammation. Lower AGEs means a lower risk of developing frozen shoulder.
See below for more information. How to lower your A1c: The complete guide.
Additionally, maintaining a consistent stretching and physical activity routine is important to maintain shoulder range of motion. Although you can’t completely control whether you get frozen shoulder, you can prepare for the best possible outcome.
Timeline for onset of symptoms
Early signs can be so subtle that you may not notice it, so it’s important to be on the lookout for persistent shoulder pain or stiffness.
Most frozen shoulders eventually improve on their own, but the process is slow and involves various stages of freezing, freezing, and thawing discomfort.
The freezing stage lasts about 6 weeks to 9 months and is when the pain and restriction of movement are the most severe. During the freezing stage, pain decreases but mobility is still severely limited and usually lasts 4 to 6 months.
treatment options
Most people first choose nonsurgical treatments such as physical therapy or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Some people consider steroid injections to reduce joint pain and improve range of motion.
However, if you have diabetes, it’s important to know that steroid injections can significantly increase your blood sugar levels for up to a week. Always consult your care team before proceeding with this type of treatment.
These nonsurgical measures are effective for many people. However, if symptoms do not improve, more intensive options such as capsular release or arthroscopic surgery followed by physical therapy may be recommended.
Exercises and stretches to help treat frozen shoulder
Jenna Peitz, a physical therapist at Accelerated PT & Wellness, offers the following advice:
Here are two exercises she recommends to help you regain range of motion in your shoulders.
table slide/table walk
Sit at the table with your palms facing down. Lean your hips forward and move your hands away from your body. If it hurts too much, start with your thumb facing up.
Repeated shoulder extension method using the McKenzie method
Stand facing a table or counter and place your hands there. Turn your palm toward your thumb and away from your arm. Squat until it feels tight, then relax and repeat.
These low-intensity exercises can be performed in sets of 10 to 20 repetitions, 4 to 6 times per day.
Unlike regular exercises, the focus here is on restoring range of motion, so volume and intensity are less important.
Each case is different, so it’s important to consult a physical therapist to tailor the exercises to your situation, Peitz says, but these are a good starting point.
What not to do if you get frozen shoulder
There are several things that may seem helpful, but can actually make the condition worse.
Do not use shoulder slings
It’s tempting to try to keep your shoulder still to reduce pain, but restricting movement can make shoulder stiffness worse. Continue to use your arm to maintain range of motion (unless your doctor specifically recommends a sling after surgery).
Don’t stop using your arms completely
Although it will be painful, gentle movements of the arm will help the healing process. Just avoid lifting heavy objects.
No need to look for a “magic cure”
Improving frozen shoulder takes time, and while many websites promote quick-fix solutions, most of these treatments are ineffective and potentially harmful.
Establishing Control: Frozen Shoulder Do’s and Don’ts
Frozen shoulder affects many people with diabetes, but there are many things you can do to prevent or treat frozen shoulder.
- Manage your blood sugar levels as best you can.
- Before you get frozen shoulder, do shoulder exercises and stretches regularly.
- Treat pain with anti-inflammatory drugs (NSAIDs).
- Work with a physical therapist to strengthen your shoulder and increase your range of motion.
- If nothing else works, surgery can be considered.
- Do not use a shoulder sling or completely stop using your arm.
Frozen shoulder can be painful and limit many of your daily activities, but the good news is that with proper treatment, the condition will eventually resolve in most cases.
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