There’s a difference between a slightly sore, stiff shoulder and a more serious condition called frozen shoulder. And no, it doesn’t mean getting the cold shoulder!
Frozen shoulder is a painful, restrictive shoulder condition that disproportionately affects women between ages 40–60, the typical window of menopausal transition. Hormonal changes during this period, especially falling estrogen levels, can cause stiffness and inflammation in connective tissue.
Fortunately, there are several effective treatments for frozen shoulder, as well as plenty of advice for how to sleep with frozen shoulder, and strategies for prevention.
Key takeaways
- Frozen shoulder is a painful condition that most often affects those in menopause because of estrogen decline, which contributes to joint inflammation and can lead to stiffness and discomfort that affect daily life.
- Estrogen plays a possible supportive, but not primary, role in treatment for frozen shoulder during menopause.
- Nighttime comfort strategies and prevention through movement are key to long-term recovery and regaining full range of motion.
- Treatments for frozen shoulder center on restoring the range of motion through physical therapy, injections, or gentle movement.
What is frozen shoulder?
Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain and stiffness in the shoulder due to the thickening and tightening of the shoulder joint capsule. This condition makes it difficult to move the shoulder.
Frozen shoulder is most common among people between 40 and 60 years old, and occurs more often in women than men. This condition develops in three stages. In some cases, a full recovery from frozen shoulder may take as long as three years.
Why frozen shoulder is more common during menopause
Why is frozen shoulder more common during menopause? In short, there is a connection between frozen shoulder and female hormones. During the menopausal transition, the body produces less estrogen. The decrease in estrogen levels affects tendons, bones, muscles, and joints, putting people in perimenopause and postmenopause at greater risk of shoulder pain.
Additionally, estrogen levels play an important role in the body’s inflammatory response. When the levels are high, estrogen has an anti-inflammatory effect, while lower levels of estrogen can increase joint inflammation. This lack of estrogen can make frozen shoulder worse, as the condition is characterized by chronic inflammation.
Other risk factors in the frozen shoulder menopause connection include:
- Decreased physical activity
- Thyroid dysfunction
- Diabetes
For this reason, it is recommended that frozen shoulder is treated holistically by considering all factors of health (including menopause).
Does estrogen help with frozen shoulder?
So, does estrogen help frozen shoulder? The evidence isn’t conclusive, but recent research suggests that hormone balance may support recovery. In a retrospective study conducted by Duke University’s Departments of Orthopedics and Obstetrics & Gynecology, researchers found that fewer women were diagnosed with frozen shoulder after receiving hormone replacement therapy (HRT) compared to those who had not received hormone therapy.
While estrogen therapy isn’t a clinically approved treatment for frozen shoulder, it may indirectly reduce risk by improving joint lubrication, circulation, and inflammation control. For the best results, always consult with a healthcare provider when considering HRT for menopause for individualized recommendations and support.
Frozen shoulder menopause treatment options
Despite the mild-sounding name, frozen shoulder during menopause can have a negative impact on quality of life and leads many to seek treatment options. People experiencing frozen shoulder don’t just have light shoulder pain, but rather intense pain and mobility issues that affect their daily activities. In fact, a study found that 50% of patients were still experiencing shoulder pain or stiffness seven years after the onset of frozen shoulder.
Even though frozen shoulder generally gets better without surgery, the long period of disability can deprive individuals of their routines for years, even affecting work and recreation. Frozen shoulder treatment focuses on controlling pain and restoring strength and motion.
What is the best first-line treatment for frozen shoulder during menopause?
The first treatment recommendations for frozen shoulder during the menopausal transition include:
- Heat and gentle movement. Applying heat and practicing gentle movement increases circulation before stretching, easing some discomfort.
- Physical therapy. Practicing specific exercises and stretches to help restore the range of motion. These are typically done under the supervision of a physical therapist or in a home exercise program. Always consult with a specialist before starting physical therapy.
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs). Anti-inflammatory medications like aspirin and ibuprofen can reduce pain and swelling in the shoulder.
- Steroid injections. A cortisone shot is a strong steroid injection that’s injected directly into the shoulder joint. Injections reduce inflammation and help manage pain.
Can frozen shoulder go away without surgery?
Yes, frozen shoulder can go away without surgery, and there are several non-surgical treatment options medical experts recommend, including physical therapy, NSAIDs, and steroid injections.
Patients may also explore alternatives to these first-line treatments, such as acupuncture, which has been shown to reduce pain and improve shoulder function.
What surgery options exist for persistent frozen shoulder symptoms?
If first-line treatments and other conservative methods aren’t providing relief, there are additional options for those experiencing frozen shoulder. A doctor may recommend surgery to stretch and release the restricted joint capsule, especially during the “Frozen” stage of adhesive capsulitis.
- Hydrodilatation. Hydrodilatation is a procedure that involves injecting sterile fluid (a mixture of saline and local anesthetic) into the shoulder joint. This expands and stretches the shoulder joint capsule, breaking adhesions that cause stiffness.
- Arthroscopic surgery. A shoulder arthroscopy releases tight tissue by cutting through portions of the joint capsule.
- Manipulation under anesthesia. This procedure involves putting a patient to sleep so a doctor can force movement in the shoulder, causing tissue to stretch and tear, increasing a person’s range of motion. Manipulation and arthroscopy are often used in combination.
Optimize health to treat frozen shoulder during menopause
While there are many treatment options, one of the important things a person can do is make sure they are managing other health conditions that might be contributing to the frozen shoulder. Doing so can help speed up frozen shoulder recovery.
Some steps to take include:
- Address thyroid problems. Thyroid disorders have been connected to an increased risk of experiencing frozen shoulder.
- Manage diabetes and monitor symptoms. People with diabetes are five times more likely to have frozen shoulder than those without. Though it is not completely understood why, individuals with diabetes should understand the increased risks for frozen shoulder and monitor symptoms accordingly.
- Maintain a healthy diet. Menopause causes fluctuations in estrogen production, which can lead to muscle in joint pain. Focusing on getting the right nutrition for menopause can reduce the risk of musculoskeletal pain.
- Engage in consistent exercise to build strength. Is weight training safe during menopause? Absolutely! In fact, exercise in menopause can improve joint stability and mobility. While it may not prevent frozen shoulder, it helps individuals stay healthy and even reduce diabetes risk.
Multiple factors can contribute to frozen shoulder. Luckily, there are steps people can take to keep frozen shoulder at bay.
How to sleep with frozen shoulder: What’s the best sleep position?
Getting a restful sleep is hard when the body is in pain. Sleep disruption is a top concern for people experiencing frozen shoulder, which limits how someone can comfortably sleep. This leads to one of the most common questions patients ask: “How do I sleep with frozen shoulder?”
Try these sleeping tips for frozen shoulder:
- Always properly support the head and neck
- Sleep on the back, with a pillow under the elbow for support
- Sleep on the side (lying on the shoulder that’s not frozen), hugging a pillow to the chest
- Engage in gentle stretching before getting in bed
- Use a heating pad or take a warm shower before bedtime
- Avoid lying on the affected side, as this can make discomfort worse
- Keep over-the-counter medications nearby for pain relief
- Try using topical analgesics with menthol or capsaicin for more targeted relief
With the right routine, individuals can learn how to sleep with frozen shoulder and still wake up feeling refreshed.
Preventing frozen shoulder during menopause
After reading about frozen shoulder, the prospect of dealing with the symptoms can be scary — especially during menopause when so many other symptoms affect quality of life.
Consider taking these steps to prevent frozen shoulder during menopause:
- Practice light resistance training or yoga to maintain consistent shoulder mobility
- Avoid prolonged immobility, like sitting or standing for long periods
- Pay attention to nutrition and diet to support hormonal health
- Talk to a care provider about early evaluation for thyroid or diabetic symptoms that may aggravate inflammation.
HRT for menopause may also be an option for preventing frozen shoulder. While hormone therapy is not a validated treatment for adhesive capsulitis, research has linked HRT with frozen shoulder prevention. In a 2023 study, researchers found that patients not undergoing hormone therapy for menopause were nearly twice as likely to develop frozen shoulder. More research is needed to determine if HRT is truly protective against frozen shoulder, but the initial evidence is promising.
When to see a specialist
Pain and stiffness in the shoulder can make it difficult to complete daily activities. When is the right time to see a specialist about frozen shoulder?
It’s time to seek an orthopedic evaluation if you meet any of the following criteria:
- Experiencing numbness or tingling in the shoulder
- Experiencing pain in the shoulder when at rest
- Persistent pain or stiffness lasts two weeks or more
- Discomfort is interrupting sleep quality
- Accomplishing day-to-day activities is increasingly difficult
If left untreated, frozen shoulder will only get worse and cause more discomfort. It’s important to address the issue as soon as possible. A doctor may recommend an MRI or ultrasound may rule out other conditions, like rotator cuff tears or arthritis, which require a different set of treatments.
Don’t try to wait out painful frozen shoulder during menopause. Consult with an orthopedic and menopause specialist for the best integrated care and treatment plan.
FAQ
How do you avoid frozen shoulders during menopause?
You can help prevent frozen shoulders during menopause by maintaining a regular exercise routine, eating a healthy diet (including anti-inflammatory foods), and keeping tabs on your overall health. HRT for menopause may also help prevent frozen shoulder, as it can support bone health and manage joint and muscle pain.
How do you fix a frozen shoulder?
There are several conservative treatments to fix a frozen shoulder, including: physical therapy, heat and gentle movement, NSAIDs, and steroid injections. When these treatments don’t work, a clinician may recommend interventions like hydrodilatation, arthroscopic surgery, and manipulation under anesthesia.
What is the best sleep position for frozen shoulder?
The best sleep position for frozen shoulder depends on whichever one makes you most comfortable. The most recommended positions are:
- On the back, with a pillow under the elbow for support
- On the side, lying on the unaffected shoulder, while hugging a pillow
It is also recommended you keep your head and neck supported to prevent additional pain and stiffness.
What supplements are good for frozen shoulder?
Supplements for frozen shoulder are those that support tissue and joint health, and have anti-inflammatory properties.
- Vitamin D
- Turmeric
- Omega-3 Fatty Acids
- Collagen
- Magnesium
- Calcium
- Protein
Incorporating anti-inflammatory foods to your diet can help reduce the intensity of your symptoms.
Holistic health for menopause
Hormonal changes during the menopausal transition don’t just cause hot flashes and mood swings. There’s also bone density loss, sleep disruption, and, yes, even frozen shoulder to contend with. Perimenopause and menopause are a unique and often overlooked part of women’s midlife health. However, everyone deserves safe, personalized solutions from trusted clinicians.
Whether you’re seeking guidance on symptom management or looking for individualized medication plans, Carrot provides life-changing menopause care backed by clinical expertise. Learn how to ask your employer to offer Carrot as a benefit.
