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The pocket around the ball and socket is called the capsule, and when it gets inflamed it makes the shoulder sticky causing a condition called adhesive capsulitis, which is commonly known as a frozen shoulder. This is a very common problem, particularly among diabetics and has two main problems that must be treated: 1) inflammation, which is the primary problem, not like in other shoulder problems where inflammation is secondary, 2) stiffness, which starts to set in after the inflammation has been there for several months.
Most of the time, I see patients with this problem a few months after they started having symptoms and after they have tried taking NSAIDs or even oral Prednisone, neither of which have been shown in the literature or in my experience to provide significant benefit for this problem. If patients still have constant pain and difficulty sleeping at night, they are likely still in the inflammatory phase, and in my opinion the best treatment is an ultrasound guided injection of cortisone into the ball and socket joint so the injection makes contact with all of the inflamed capsule. Within a week or so, the inflammation should be gone, and what is left is the stiffness which gets better with home stretching exercises that you learn from a physical therapist.
Frequently Asked Questions
How do I know if I have a frozen shoulder? If you cannot raise your harm above your head, bring it up behind your back, or bring it as far away from your body as you can do those motions with the opposite side, you may have a frozen shoulder.
Is a frozen shoulder something that needs to be seen right away? I consider this to be an urgent problem that needs to be evaluated within a few weeks of the onset of symptoms for two reasons: 1) it is very painful and has a significant effect on quality of life, and 2) the sooner you treat the inflammation, the sooner you can break out of the frozen phase and into the frozen phase, which gets better with the home stretching exercises.
Do I have to have a cortisone shot? My job is not to tell you what to do but to share with you what treatments I think are most likely to give you relief. If you do not want a cortisone shot and you are able to take NSAIDs, we can try those first to see if you get enough relief from the pills to be able to do the home stretching exercises. If you are getting better, great! If you are not getting better we can always reconsider the cortisone injection again down the road, if you like.