Signs of a Frozen Shoulder

A frozen shoulder is a common cause of shoulder pain and discomfort. In fact, a frozen shoulder is the second most common cause of shoulder pain (right behind rotator cuff tendonitis/bursitis), but the condition may be harder to diagnose. Many people who have a frozen shoulder are incorrectly diagnosed as having bursitis. I think it is safe to say, that frozen shoulder is the most commonly misdiagnosed problem of the shoulder joint.

Differentiating between bursitis and frozen shoulder can be confusing, but with an appropriate examination your heathcare provider should be able to distinguish these conditions. Interestingly, special tests or interventions are generally not necessary, and the best way to differentiate these conditions is with a careful physical examination.

Signs of Frozen Shoulder

• Shoulder Pain: Typical pain of a frozen shoulder is described as a dull, aching pain. Often the discomfort surrounds the front, back, and side of the shoulder. At times the pain will extend down the upper part of the arm. Usually the pain is manageable with the arm held at your side, but even small movements may cause significant discomfort.
• Limited Range of Motion: The hallmark finding of patients with a frozen shoulder is limited range of motion. While many shoulder conditions can cause pain of the joint, frozen shoulder is also characterized by significant stiffness. 
• Difficulty with Activities: Many typical activities, such as brushing hair, putting on shirts/bras, fastening a seat belt, can become very difficult. The most common problem is reaching behind your back, and patients often notice that their unaffected shoulder can reach much higher up their back than their frozen shoulder.

Other shoulder conditions may cause difficulty when you try to move your arm, but the key to diagnosing a frozen shoulder is when your examiner is also unable to move your arm. For example, while patients with a rotator cuff tear may not be able to lift their arm, their examiner can certainly lift the arm up overhead. In patients with a frozen shoulder, the joint is not just weak, but actually stiff.

Almost always, a frozen shoulder can be diagnosed on physical examination, and no special tests are needed. An X-ray is usually obtained to ensure the shoulder joint appears normal, and there is not evidence of traumatic injury or shoulder arthritis.

An MRI is sometimes performed if the diagnosis of frozen shoulder is in question, but this test is better at looking for other problems, rather than looking for frozen shoulder. If an MRI is done, it is best performed with an injection of contrast fluid into the shoulder joint prior to the MRI. This will help show if the volume of the shoulder joint, which may be small in patients with a frozen shoulder.

Treatment of a Frozen Shoulder

As with any condition, it is critical that the diagnosis be accurate in order for treatment to be successful. Because frozen shoulder is often misdiagnosed, treatment is sometimes not ideal. Many patients with a frozen shoulder receive treatment for a rotator cuff condition when that's not really their problem. Frozen shoulder treatment requires aggressive stretching, and can last many months--even years. Fortunately, most patients with a frozen shoulder are able to recover normal function of the joint. If you feel you are not progressing in the treatment of your shoulder pain, just be sure you do not have a frozen shoulder joint that could be causing your symptoms.

A Word From Verywell

Frozen shoulder is a common but often misdiagnosed shoulder problem. Frozen shoulder causes pain and difficulty moving the arm, but the most important difference is that the restriction in movement occurs even when you try to help the shoulder move. With most shoulder problems, while movements may be painful, with a little help the joint can be moved. However, with frozen shoulder, the joint literally becomes stuck. Having a proper diagnosis will help to guide the treatment of frozen shoulder.