Frozen shoulder is one of those things you might hear about but never really think about — until it happens. Unfortunately, it’s not uncommon for people with diabetes, affecting 10 to 30 percent, by some estimates, compared to 2 to 10 percent of the general population.
In this post, I’ll cover how to diagnose, prevent, and treat frozen shoulder, along with what to avoid if you have it.
Key Points:
- High blood sugars contribute to the development of frozen shoulder, causing stiffness and immobility in the shoulder joint.
- Managing blood sugar levels and maintaining a consistent stretching routine can help prevent frozen shoulder.
- Non-surgical treatments, such as physical therapy and NSAIDs (non-steroidal anti-inflammatory drugs), are the first steps.
- Surgery is an option if symptoms persist.
What is frozen shoulder?
Frozen shoulder, also known as “adhesive capsulitis,” develops gradually as the shoulder joint stiffens, eventually becoming “frozen.”
This can make it hard to lift your arm above your head or even to shoulder height, with any movement causing significant pain. Over time, basic tasks like dressing or showering can become difficult.
Although the exact link between diabetes and frozen shoulder isn’t fully understood, research suggests high blood sugars cause AGEs (advanced glycation end products) to form, which stiffen tendons and ligaments.
This, combined with impaired circulation, leads to inflammation and immobility. Those aged 40 to 60, especially women, are at higher risk, particularly if they’ve had diabetes for many years.
How to diagnose frozen shoulder
This condition is usually diagnosed based on signs and symptoms.
A physician will test both your active range of motion (where you move your shoulder) and passive range of motion (where they move your shoulder for you). Limited movement in both cases often confirms the diagnosis.
How to prevent getting a frozen shoulder
Unfortunately, there’s no guaranteed way to prevent adhesive capsulitis.
However, keeping blood sugars in check can help reduce the formation of AGEs, which contribute to joint stiffness and inflammation. Fewer AGEs mean a lower risk of developing frozen shoulder.
Read more in: How to Lower Your A1c: The Complete Guide.
Beyond that, maintaining a consistent stretching and physical activity routine is crucial to preserving your shoulder’s range of motion. While you can’t completely control whether you’ll get frozen shoulder, you can set yourself up for the best possible outcome.
Timeline for developing the condition
The early signs can be so subtle that you may not even notice them, so it’s important to stay mindful of any persistent shoulder pain or stiffness.
While most frozen shoulders do eventually improve on their own, the process is slow and involves different stages of discomfort: freezing, frozen, and thawing.
The freezing stage lasts about 6 weeks to 9 months, with pain and limited motion being the most intense. In the frozen stage, pain decreases but mobility remains severely restricted, typically lasting 4 to 6 months.
Treatment options
Most people will opt for non-operative treatments first, such as physical therapy and non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen.
Some may also 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 cause significantly elevated blood sugar levels for up to a week. Be sure to consult your care team before pursuing this type of treatment.
These non-operative measures are effective for many people. However, if symptoms do not improve, more intensive options such as open capsular release or arthroscopic surgery, followed by physical therapy, may be recommended.
Exercises and stretches that help treat frozen shoulder
Jenna Peitz, a physical therapist at Accelerated PT & Wellness, offers the following advice:
“You want to move the shoulder to the point of discomfort and then slightly beyond, but don’t be overly aggressive. This will coax the tissue into remembering how it’s supposed to move.”
Here are two exercises she recommends to help regain your shoulder’s range of motion:
Table slides/table walks
Sit at a table with your palm face down. Lean forward at the waist and slide your hand away from your body. If it’s too painful, start with your thumb pointing up.
McKenzie method of repeated shoulder extension
Stand facing a table or counter and place your hand on it. Rotate your palm towards the thumb as you turn to face away from your arm. Squat until you feel tightness, then relax and repeat.
These low-intensity exercises can be done in sets of 10-20 reps, four to six times per day.
Unlike typical exercise, the focus here is on restoring range of motion, so volume and intensity are less important.
Every case is different, so it’s important to consult a physical therapist for exercises tailored to your situation, says Peitz, but these are a good starting point.
What not to do if you have a frozen shoulder
There are a few things that might seem helpful but could actually make this condition worse:
Don’t use a shoulder sling
It’s tempting to keep your shoulder immobile to reduce pain, but limiting movement can worsen stiffness. Keep using your arm to maintain its range of motion (unless your doctor specifically recommends a sling after surgery).
Don’t stop using your arm completely
Even though it’s painful, gently moving your arm helps the healing process. Just avoid lifting heavy objects.
Don’t look for a “magic cure”
Frozen shoulder takes time to improve, and while many websites promote quick fixes, most of these remedies are ineffective and potentially harmful.
Taking control: dos and don’ts for frozen shoulder
While frozen shoulders affect many people living with diabetes, you can do a lot to prevent or treat a frozen shoulder.
- Manage your blood sugar levels as well as possible.
- Exercise and stretch your shoulders regularly BEFORE you develop frozen shoulder.
- Treat the pain with anti-inflammatory medication (NSAIDs).
- Work with a physical therapist to strengthen your shoulder and increase range of motion.
- If nothing else works, you can consider surgery.
- Don’t use a shoulder sling or completely stop using your arm.
A frozen shoulder can be painful and limit you in many of your daily activities, but the good news is that the condition almost always goes away eventually if you treat it right.
You got this!
Did you find this article helpful? Click Yes or No below to let us know!
Tony
I had a severe case about 5 years ago and had the usual treatments.
I was referred to an orthopaedic surgeon and was given a ‘hydrodilatation’ procedure that helped me. I was advised to allow three weeks for full improvement (and warned it only works in 70% of cases). Basically, a mix of anaesthetic, steroid and saline is accurately injected by a radiologist using x-Rays, so it’s safer and less painful than surgery.
There was an immediate improvement, then I had six weeks’ physio to get the full movement back. I still do stretches (when I remember!)
U.K. based, but I presume this treatment is available elsewhere.
Bill Wilson
This info has been more helpful than the Dr. I’ve still not seen.. lol diagnosed borderline type 2 over a yr. ago,.. but kept under control since, now this burning shoulder drove me to diagnose myself, sad but true I know. Thank you so much
Lucy saw
Hi I have two frozen shoulders
I am 38 type 1 diabetic
I Was on a zolodex injection for almost a year and now 8 weeks ago I had a hysterectomy.
I saw a orthopaedic surgeon last week and he told me that my shoulders are diabetes and hormone related and there really is nothing I can do
He said don’t have physio therapy it could make it worse
I am in a mess right now
I really could use some advice if anyone can help
I can’t get dressed and sleeping is a real issue
Than k you
Lucy
Christel Oerum
I’d see another doctor for a second opinion. You’re not destined to live in pain for the rest of your life. Many people living with diabetes have had frozen shoulders and have received treatment
Alison Carr
Could Ben or Christiel kindly do a video of the exercises? Ben gives a pretty good description, but seeing them would be more helpful. Perhaps the videos can be included in an updated version of the article or Christiel could do them on the Facebook page.
Thank you, Alison Carr
Christel Oerum
That is a great idea! It’s not something I have the bandwidth for at this time but I’ll definitely keep it in mind as a possible future project
Mathilde Roe
I started getting frozen shoulder in my mid-twenties. After completely cutting out refined sugar/fruit juice etc. I was symptom free after around two weeks. As soon as I eat sugar on two consecutive days or have a really high blood sugar it flares up slightly. My HbA1c has stayed the same (around 7%).
Pedro Paramo
It happens the same to me, if I get under control my BSL the pain completely disappears in two weeks.
Joyce
I have type 2 diabetes and it’s controlled and had this frozen shoulder for about 4 months already, my doctor said it’s related to my type 2 diabetes but I told him it’s controlled, I insist to get a shot but he said it could contradict with my sugar so he advised me to do therapy and exercise for a few weeks and if it’s still painful, I have no choice but to take a shot. Do you think Acupuncture will work? Do I need to see a Chiropractor?
Christel Oerum
I don’t believe there is any clinical evidence that acupuncture or chiropractors can help with frozen shoulders. I would follow your doctors recommendation or see another doctor for a second opinion.
Oscar Rodriguez
I’ve had a similar experience but only when I am weight lifting. It seems to be the same symptoms, except only after I weight lift. The pain also seems to go away when I box or when I focus on strengthening by my back with light weights. Is this the same ? Before I started boxing, I had three cortisone shots in to my shoulder to relive the shoulder pain. The shots were after a few months of rest. Then I would start lifting weights and then the symptoms would gradually happen again.
Christel Oerum
Since you have had injuries it could be related to that but I can’t say exactly why you’re experiencing the pain. I’d recommend seeing a specialist and get it checked out
Lena
I had this and it was quite painful. It took months and months to get an appointment with a specialist who, when I finally saw him, told me that the most important thing is to treat as soon as you have symptoms. I regret that I wasn’t insistent enough on getting in with a specialist earlier. Treatment included a cortisone shot, an anti-inflammatory, a muscle relaxer, and physical therapy 3X/week for several months. It worked, and I now have full range of motion but with some soreness sometimes. I was fortunate that my insurance generously covered physical therapy. If you can’t go to physical therapy so often or for so long, be diligent about doing the exercises and stretches at home. And don’t be afraid to be the squeaky wheel to get an appointment with the doctor you need to see as soon as possible.
Phillip
Goodday i have a frozenshoulder after an operations . Thanks for all the information. My question is can you use a shoulder support . Thank you. Phiilip
Christel Oerum
I’m not in a position to be able to guide you on that. Please consult with your physical therapist or the doctor who did the operation. Hope you have a swift recovery
Ann
This article was very helpful. I did have a frozen shoulder and had thawed thankfully. I was curious if this type of AGE glycation can happen in other areas of the body? For example the front hip/ groin area? Right side only. Thanks for any help.
Christel Oerum
Most often it’s the shoulder that gets affected, but knees or less often hips can also get affected. I’d suggest you see a doctor for proper diagnosis and treatment