Diabetes

Frozen Shoulder in Diabetes: Symptoms, Causes, Stages, Exercises, and Treatment

Severe pain and rigidity in shoulder movement could mean that you are suffering from frozen shoulders. But can diabetes cause frozen shoulders? How is adhesive capsulitis treated?

Have you ever felt stiffness in your shoulders while doing movements such as changing clothes or lifting something, especially if you have diabetes? This feeling of rigidity, pain, and loss of mobility around the shoulder region is called ‘Adhesive Capsulitis’, commonly known as frozen shoulder.

Diabetes and Frozen Shoulder

Diabetic patients complain about jamming of the shoulder joint at some point in their lifetime. Long-standing diabetes is touted as a leading factor for this condition. It is five times more common among diabetic patients than non-diabetic patients.

It occurs in 10-30% of diabetic patients, especially among females in the age group of 40-60 years. Other predisposing conditions like injury, surgery and debilitating conditions like stroke may also cause frozen shoulders.

Symptoms of Frozen Shoulder in Diabetes

Frozen shoulder is a common condition in people with diabetes, characterized by stiffness and pain in the shoulder joint. It often progresses slowly over time and can significantly impact daily activities.

Symptoms of Frozen Shoulder in Diabetes:

  • Gradual onset of shoulder pain
  • Increasing stiffness in the shoulder joint
  • Difficulty with shoulder movements, especially reaching overhead or behind the back
  • Pain that worsens at night, affecting sleep
  • Limited range of motion in the shoulder
  • Pain and stiffness that may persist for months or longer

These symptoms can vary in severity from person to person and may worsen with time if not managed appropriately. If you experience these symptoms, it’s important to consult with a healthcare professional for an accurate diagnosis and treatment plan

Stages of Frozen Shoulder

The American Association of Orthopaedic Surgeons (AAOS) classify this condition into three stages

  • Freezing Stage:

It’s a very painful stage marked with restricted movement of the shoulders. It lasts for a few weeks to months.

  • Frozen Stage:

As the name suggests, the joint becomes frozen or stiff and mobility is completely lost. The pain lessens and happens only if you stretch your arm. It lasts 5-6 months, or maybe more.

  • Thawing Stage:

The shoulder is recovering and regains mobility. The pain subsides but episodes can happen occasionally. Overall one can move his shoulder and perform all the activities which he/she is unable to do before. This lasts for months to many years.

Treatment For Frozen Shoulder

Frozen shoulders can be cured by a combination of curative and rehabilitative therapies. Once diagnosed, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, diclofenac, etc. are prescribed to alleviate pain and reduce inflammation of the joints.

Heat fomentation can also be given to get relief from the stiffness of joints. In severe cases, corticosteroids are injected into the inflamed area of the shoulder joint.

Alternatively, physiotherapy is also given to keep the joint in motion. In severe cases, surgery is performed on the joint capsule to loosen the stiff muscles and other associated tissues like ligaments, tendons, etc., to bring back mobility.

Home Remedies For Frozen Shoulder

Frozen shoulder develops gradually which means intervention should start at the beginning of initial signs and symptoms. One should start by doing mild stretching and exercising the shoulder joint daily so that mobility doesn’t hamper. Exercises increase the blood flow thus reducing pain to some extent.

Frozen Shoulder Diabetes Exercises

  • Periarthritis shoulder exercises like stretching ease the feeling of discomfort and prevent the progression of this condition in mild to moderate cases.
  • Some yoga asanas like reverse prayer pose, cobra pose, bow pose can be added to your daily routine to strengthen the back and shoulder muscles.
  • All the exercises should be performed under the expert guidance of a physiotherapist without overstretching the joint.

What Not To Do If You Have a Frozen Shoulder?

  • DO NOT keep the affected arm rested for a long time. Controlled and limited movements of the joints should be encouraged to keep the blood supply and motion intact.
  • DO NOT lift the heavyweights in a sudden motion. This may lead to severe injury in the shoulder capsule leading to periarthritis.
  • DO NOT sleep on the sore side, if you are diagnosed with a frozen shoulder. This can injure the supporting structures and can worsen the pain.
  • DO NOT miss your physiotherapy sessions even if you are in pain. The chances are you want to keep resting your affected arm to prevent pain but this can add up to your woes by making the arm joint more rigid and achy.
  • Control your blood sugar levels as the severity of adhesive capsulitis is directly linked to the amount of blood sugar level in your system.

Don’t Have Time To Read?

  • Frozen shoulder, technically known as adhesive capsulitis is characterized by pain, stiffness, and immobility of the shoulder joint.
  • It occurs in the mid-age group between 40-60 years and is common in females.
  • High blood glucose level produces some harmful by-products which damage the capsule of the shoulder joint leading to pain and stiffness subsequently.
  • Frozen shoulder has three stages, comprising periods of extreme pain as in the freezing stage, with periods of limited movement (Frozen stage), and finally resolution of pain with regaining mobility(thawing stage).
  • It can be treated with over-the-counter anti-inflammatory drugs like ibuprofen with a combination of physiotherapy and mild exercises.
  • It can be prevented by controlling your blood sugar level and keeping the joint in motion by daily stretching the joint mildly.

Also Read: Weight Loss in Diabetes

Friendly Asked Questions

How is Frozen Shoulder Diabetes Treated?

Mild to moderate cases resolve by the use of NSAIDs and physiotherapy whereas in severe cases surgery is required to loosen the tightened capsule.

Is Frozen Shoulder a Symptom of Diabetes?

Yes, it could be one of the complications of long-standing uncontrolled diabetes. Consult your diabetologist to know more.

Does a Frozen Shoulder Hurt All The Time?

The pain of a frozen shoulder hurts most in the freezing stage when inflammation just sets in. After that, it occurs while doing any activity. It develops gradually and takes months to years before it finally subsides.

How Do You Know When a Frozen Shoulder is Thawing?

Thawing is the last stage of the frozen shoulder where the range of motion of the arm improves after a long period of pain and stiffness. This stage is marked by less pain and improvement of joint mobility.

How Long Can You Have Frozen Shoulders?

Frozen shoulders can last from several months to years. The average recovery for a diabetic may take three years.

What Happens if the Frozen Shoulder Is Left Untreated?

Pain and stiffness get worse with restriction of limb movement. However, it may subside on its own after several months. But if the treatment is not sought, mobility is compromised. Consult the doctor so that these symptoms don’t get worse.

Why is Frozen Shoulder Common in Diabetes Patients?

High levels of blood sugars or hyperglycemia are associated with an increased tendency to develop frozen shoulders. Several studies suggest that it is five times more common in diabetic patients than non-diabetic persons. It is because of the formation of advanced glycosylation end products(AGEs) which are considered harmful for supporting structures of the shoulder joint.

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