Shoulder Pain Not Improving? 5 Signs It May NOT Be Frozen Shoulder

Many patients come to my chamber with a typical complaint, “Doctor, I am suffering from Frozen Shoulder. I am taking medicines, and doing physiotherapy for 2-3 months, but I am not getting better. What to do now?”

Here is the uncomfortable truth: Not all shoulder pain is Frozen shoulder.

Frozen shoulder is one of the most over-diagnosed conditions in North East. Almost all shoulder pain patients get labelled as Frozen Shoulder.

If your shoulder pain is not improving, then chances are that you are suffering from something else.

Let’s discuss 5 signs which can point you in that direction.

Look out for

The 5 Warning Signs

1.Your Shoulder Movement Is Still Almost Normal

Frozen shoulder is marked by severe stiffness.

In such patients, there is difficulty in –

Reaching behind the back
Overhead movement
Combing hair etc

If your shoulder movement is more-or-less ok, then you have to think of other conditions such as –

Rotator Cuff tears
Impingement syndrome
Tendinitis etc

2. Your Pain Is Not Improving With Physiotherapy

True Frozen Shoulder generally improves with physiotherapy and exercises over the course of a few weeks to months. Infact, some patients undergo spontaneous recovery also, although that may take 12-18 months.

In case you are not improving with physiotherapy or your pain is getting worse, then you may be suffering from something else.

3. Your Shoulder Pain Started After A Minor Injury

If your shoulder pain started after a trivial fall or injury, then most likely you are not suffering from frozen shoulder.

Many patients complain of aggravation of pain following lifting objects or gym exercises or even minor incidents like pulling heavy luggage or shoulder strain while travelling.

This points more in direction of other causes like

Rotator cuff injury
Tendon tears etc

Such patients with shoulder injury not improving on physiotherapy should look for an alternate diagnosis.

4. Shoulder Pain Travels Down The Whole Arm and Forearm

Frozen shoulder pain originates from the shoulder joint but can be felt around the upper arm or upper back and neck.

But if your pain is in the whole upper limb upto the fingers and specially if it is associated with other symptoms like tingling, numbness etc, then it may point to a different cause.

In such scenarios, the culprit is usually the neck or cervical spine.

Continuing shoulder exercises may not improve the pain, rather worsen it.

5. Your Pain Is During Certain Movements Only And Associated With Clicks or Sounds

Frozen shoulder typically has limitation of movement in all directions.

However, if you feel pain only in certain activities like overhead actions, then it points to Impingement syndrome.

Secondly, such cases may be associated with clicks or sounds in the joint, often with pain.

It may also be due to a torn tendon of the rotator cuff.

What To Do When Shoulder Pain Is Not Improving

If your shoulder pain is not improving and you have any of the above warning signs, then it is time to check your diagnosis.

You should take a second opinion and try to find out the root cause.

You need a fresh approach by a shoulder specialist.

Dr Firoz Ahmed believes in a thorough clinical examination including meticulous history taking. You may be prescribed tests like XRay/CT/Ultrasound/ MRI depending on the clinical setting.

If there is an underlying cause, which is not Frozen shoulder, then you must treat that as per medical advice.

The goodnews is that all such cases do not require surgery. A majority of them can be treated without surgery with the help of various modalities of treatment available nowadays, including Orthobilogics, PRP etc. Only a few may require Arthroscopic surgery.