Imagine if one morning, you casually reached back to hook your bra only to be greeted with a jolt of pain in your shoulder. And then instead of going away, the pain gradually got worse over time, to the point that you had to invent creative and weird ways to deal with your bra—and putting on a shirt, and washing your hair, and any number of mundane daily tasks. Imagine if, eventually, you were so afraid to move your shoulder, it just got kind of…stuck.
That’s frozen shoulder, or what doctors (less dramatically) call adhesive capsulitis. It’s a mysterious condition, since there’s usually no specific injury that causes it, Sara Edwards, MD, an orthopedic surgeon at the University of California San Francisco, tells SELF. What is clear: Frozen shoulder is common, particularly among women in their 40s and 50s (right around the time that perimenopause begins), and it can be seriously debilitating—taking months to years to finally go away. Yet hardly anyone is talking about it.
“That’s what I’m struck by,” Dr. Edwards says. “I see at least one patient a day who has frozen shoulder, and most have never heard of it before.”
Here’s a primer on the signs of a deep freeze ahead, and what to do about it.
Frozen shoulder 101
Frozen shoulder is caused by trouble in the joint capsule, Gabriella Ode, MD, a sports medicine specialist and surgeon at the Hospital for Special Surgery, in New York City, tells SELF. The shoulder joint capsule is basically a pocket of strong ligaments and lubricating synovial fluid that anchors and stabilizes the upper arm bone within the shoulder socket. With frozen shoulder, this capsule first becomes inflamed and thickened, which leads to stiffness and pain. Over time, bands of scar tissue can form—looking like “little cobwebs,” Dr. Edwards notes—while the synovial fluid may dry up, too. Together, those conditions make it super hard to move your arm.
In some cases, Dr. Ode says, frozen shoulder follows an injury or surgery that keeps you from moving the joint (what doctors call “secondary” frozen shoulder). Usually, though, frozen shoulder just happens with no identifiable cause.
Who gets frozen shoulder?
Around 5% of the population develops frozen shoulder, but it’s up to four times more common among women than men. And, as mentioned, women between the ages of 40 and 60 are particularly vulnerable.
Many experts suspect that the hormonal changes of perimenopause are at least part of the explanation, Dr. Edwards says. “We do have estrogen receptors in our joints,” she points out, “and estrogen has anti-inflammatory effects.” Changes in estrogen levels during this time can contribute to an increase in inflammation, which is at the root of frozen shoulder.
The problem is, not much research has been done on the subject. One small study did find that women who used menopausal hormone replacement therapy (HRT) were about half as likely as non-users to have frozen shoulder (3.95% versus 7.65%). But this area of research is in its early days, Dr. Edwards says, and no one has proven that taking hormones can ward off frozen shoulder. The study experts note that these results are preliminary and should spark more studies to determine if HRT is truly protective.
