Frozen shoulder in menopausal women: Why it happens

Frozen shoulder in menopausal women is common. It impacts women who are between the age group of 40-60 years. Hormonal changes during menopause can often lead to pain in your shoulder. While there is still a need for more scientific evidence to link frozen shoulder with menopause, menopause can often lead to musculoskeletal conditions.

Menopause, which marks the end of a woman’s reproductive power, leads to the decrease of estrogen in the body, and estrogen forms a protective layer on our joints as well as bones. Read on to know more about the prevalence of frozen shoulder in menopausal women, and how it can be fixed.

What is a frozen shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition marked by stiffness, pain, and limited motion in the shoulder joint, states the National Institutes of Health. “Inflammation and thickening of the shoulder capsule lead to adhesions that restrict movement. The possible causes include injury, surgery, diabetes, and hormonal changes such as those experienced during menopause, says physiotherapist Dr Ali Irani.

Stages of frozen shoulder

There are three stages of frozen shoulder, as stated by this study, published in the Singapore Medical Journal.

1. Freezing stage

This is the painful stage. This is marked by the gradual onset of pain worsening over time with increasing shoulder movement limitation. It lasts for a period of 8 weeks to 9 months.

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2. Frozen stage

This is the advanced stage. Here, the pain may decrease, but stiffness increases, and moving is very restricted. There is no external or internal rotation. This lasts for 4 to 12 months.

3. Thawing stage

This is the recovery stage. There is a gradual return of shoulder movement and a decrease in pain. The duration of this phase is 5 months to 26 months.

Can menopause cause a frozen shoulder?

There is a prevalence of frozen shoulders in menopausal women. While menopause itself does not directly cause a frozen shoulder, hormonal changes during menopause, particularly the decrease in estrogen levels, can contribute to joint problems, including a frozen shoulder. “Estrogen plays a significant role in maintaining joint health, and its decline can increase susceptibility to musculoskeletal issues,” explains Dr Irani.

A study conducted by Duke University School of Medicine states that estrogen helps to stimulate bone growth, decrease inflammation, and promote connective tissue integrity. The study analysed the medical records of 2000 menopausal women, who reported symptoms of frozen shoulder. It was seen that 3.95 percent of the participants who received hormone replacement therapy suffered from frozen shoulder and 7.65 percent of women who had not received estrogen replacement reported having a frozen shoulder. Therefore, HRT may help in preventing a frozen shoulder.

How can HRT help frozen shoulder in menopausal women?

Hormone Replacement Therapy (HRT) can aid in managing a frozen shoulder by addressing hormonal imbalances “Estrogen replacement may help maintain joint lubrication and tissue elasticity, potentially reducing inflammation and stiffness in the shoulder joint,” says Dr Irani. A study conducted by the Orthopaedic Journal of Sports Medicine claimed that participants who did not receive HRT had 99% more chances of adhesive capsulitis or frozen shoulder.

Other treatments for frozen shoulder in menopausal women

Aside from HRT, several treatments can be effective for managing a frozen shoulder:

1. Physical therapy

Exercises to improve range of motion and strengthen shoulder muscles. A study, published in the Singapore Medical Journal, states that home exercises that promote shoulder mobility should be encouraged.

2. Medications

There are several pain relievers and anti-inflammatory drugs that may be prescribed to manage pain and swelling. The National Institute of Health suggests acetaminophen, a non-opioid analgesic, or NSAID, Non-steroidal anti-inflammatory drugs to relieve pain, for early treatment.

3. Steroid Injections

Corticosteroids can help reduce inflammation and improve shoulder mobility. Injecting steroid injections directly into the joint is the fastest way to reduce pain as well as inflammation, states a study, published in JAMA.

Diet and physical therapy for frozen shoulder in menopausal women

Where diet is concerned, make sure to include anti-inflammatory foods in your daily meals. This means making sure to eat enough fruits, and vegetables as well as fish, flaxseeds and walnuts as they contain omega-3 fatty acids. “Avoid processed foods, sugary drinks, and excessive alcohol. Maintain adequate hydration,” says Dr Irani.

As for physical therapy, stretching exercises are great for treating frozen shoulders. They improve the pliability of the joint capsule as well as promote shoulder stability. Heat/Cold therapy can also help to manage pain and inflammation in the area.

What is therapeutic ultrasound for frozen shoulder in menopausal women?

A therapeutic ultrasound uses sound waves to generate deep heat within the shoulder tissues. It increases the temperature of the tissues and promotes local blood flow. This helps to alleviate muscle and joint stiffness, states this study, published in the International Journal of Environmental Research and Public Health. “It can also break down adhesions and scar tissue within the shoulder capsule. This therapy is often used in the early stages of frozen shoulder as part of a comprehensive treatment plan,” explains Dr Irani.

Surgical options for frozen shoulder in menopausal women

Surgery is generally a last resort when conservative treatments and pain management fail over 6-12 months, says Dr Irani. Here are a few surgical procedures that could help you. Manipulation Under Anesthesia (MUA) is when the shoulder is moved through its range of motion under anaesthesia to break up adhesions. You may also go in for Arthroscopic Capsular Release. This is a minimally invasive surgery where small incisions are made, and instruments are used to cut through tight portions of the shoulder capsule, relieving stiffness and restoring movement.

Summary

Managing frozen shoulder in menopausal women is very common. This is due to the lack of estrogen in the body. A combination of treatments including HRT, physical exercise, a balanced diet as well as surgical interventions can help you feel better.