Adhesive capsulitis, also known as a frozen shoulder, is characterized by a painful, gradual loss of active and passive shoulder motion resulting from fibrosis and contracture of the joint capsule (1). Although other shoulder conditions can result in similar symptoms, people with hyperthyroidism are more prone to developing a frozen shoulder. As a result, if you have hyperthyroidism and are experiencing moderate to severe pain in one or both shoulders that isn’t due to a traumatic injury, then it’s possible that you have adhesive capsulitis as a result of your condition.
Adhesive capsulitis usually develops one of two ways. The primary method is gradual, which usually is the case with those who have hyperthyroidism. But it can also develop as a result of a trauma. When it’s not caused by a trauma, it can take a few weeks or months until the pain is severe enough for the person to seek medical attention. Sometimes they will only notice the shoulder pain initially, but over time they will realize that it’s also affecting their range of motion.
Adhesive Capsulitis Can Be Present In Other Conditions
Although hyperthyroidism is one of the more common conditions in which people develop a frozen shoulder, there can be other conditions that lead to this as well. This includes hypothyroidism, as well as hypoadrenalism, Parkinson’s disease, cardiac disease, pulmonary disease, and stroke (2).
The Three Clinical Phases of Adhesive Capsulitis
The literature discusses three distinct phases of adhesive capsulitis (3):
1. The freezing or painful stage. This is what I described above, as over time the pain will increase, and both the active and passive range of motion will decrease. This phase typically lasts between 3 and 9 months and is characterized by an acute synovitis (inflammation of the synovial membranes) of the glenohumeral joint of the shoulder (3).
2. The frozen or transitional stage. This stage can last from 4 to 12 months, and it’s usually when the pain is the most intense and the shoulder is the most restricted.
3. The thawing stage. This is when the pain begins to decrease and the range of motion begins to improve. This stage can last anywhere from 12 to 42 months (3).
How Is Adhesive Capsulitis Diagnosed?
As for how adhesive capsulitis is diagnosed, it can be challenging initially. A physical examination will reveal both a loss of passive and active range of motion (4). Many times it is diagnosed by ruling out other conditions, such as a rotator cuff tear, a bone contusion, or osteoarthritis.
What Are The Treatment Options For Adhesive Capsulitis?
The conventional treatment approach usually will begin with either drugs or physical therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help to reduce the inflammation, which in turn might decrease the pain (5) (6). Prednisone might also benefit some people with adhesive capsulitis, although the benefits seem to be more short term (7). Cortisone injections are also commonly used and can lead to fast pain relief and an improved range of motion (8) (9), although of course there are potential side effects as well. Sometimes arthroscopic surgery is used for adhesive capsulitis. But in most cases surgery should be a last resort.
I’m more in favor of using natural anti-inflammatory agents, such as higher doses of curcumin, resveratrol, boswellia, and fish oils. However, many times these won’t result in significant relief, and when this is the case, some type of physical therapy can be beneficial. There is some evidence that a combination of bee venom acupuncture and physiotherapy can help with adhesive capsulitis (10) (11). For those who aren’t familiar with bee venom acupuncture, this is a type of herbal acupuncture that uses bioactive compounds isolated from bee venom, combined with acupuncture. But “standard” acupuncture can also be beneficial for a frozen shoulder. Manipulation of the shoulder can be beneficial (12), and possibly even manipulation of the thoracic spine (13). And so going to a chiropractor might help, especially if you see a chiropractor that has experience working on extremities. Low-level laser therapy might also help with adhesive capsulitis (14).
In summary, people with hyperthyroidism are more prone to developing a frozen shoulder, which is also known as adhesive capsulitis. Most of these cases develop gradually, although sometimes it can be due to a trauma. Adhesive capsulitis is usually diagnosed by ruling out other conditions. Conventional treatment usually involves NSAIDs, cortisone injections, physical therapy, and in some cases arthroscopic surgery. Although natural anti-inflammatory agents probably won’t help much, acupuncture, manipulation, and low-level laser therapy might be beneficial.
I believe leaky gut causes a immediate stiff neck or overtime a frozen shoulder.
marti black says
Yep, I had it. Fortunately, I have a dynamite chiropractor, and he fixed me up. What a painful thing.
I am shocked, I have been dealing with adhesive capsulitis for over a year now. I have gone to physical therapy for as long as the insurance will allow, and it is better, but not 100%. Never did I think that it could have anything to do with my hyperthyroidism.
I really want to thank you for all of the articles that you post, they are always informative and most of the time eye opening.
Dr. Eric says
You are very welcome Linda. Thank you for taking the time to read my post!
That’s interesting ! I had 2 frozen shoulders about 10 years before diagnosed with Graves !
Yes this is very interesting. I am having a lot of right shoulder pain and have had a frozen shoulder on my left side in the past. I am wondering when you say this can be related to hypothyroidism, which I have, whether you mean untreated hypothyroidism or can it occur even when the condition is being treated/controlled?
Dr. Eric says
It seems to be more common when the condition isn’t treated, although there have been some cases where the person was managing their thyroid levels yet still developed a frozen shoulder.
I had two frozen shoulders about 2 years apart. I had hyperthyroidism but went through the radiation iodine therapy to reduce the thyroid and take medicine prior to my having the shoulder issues. So I am proof it also happens while being managed. Most painful thing I’ve ever gone through but was told it won’t happen again. Thank goodness.
I had 2 frozen shoulders 4-5 years before being diagnosed with hyperthyroidism. The doctors were puzzled as to why, always commenting it was odd being I didn’t have diabetes. Now I know. Physical therapy helped only in the thawing stage, but nothing helped with the unrelenting pain. Just had to wait through the stages and am now 100%. Thanks for the great article, Dr. Eric!
Dr. Eric says
You’re welcome Diane! Thank you for taking the time to read my blog post!
My mom was getting these cortisone shots in her shoulder, until she realized it was destroying her eye sight, and then they gave her Prednisone when she got sick and that made her eyes worse, she now is having to receive injections in her eyes to try to save what eye sight she has left. And statin drugs do the same damage
I have been suffering from adhesive capsulitis for more than four months, ruined my sleep and a lot of other things all summer. Kept getting worse with more pain and more limited motion, and more random mind-boggling jolts of awful pain. Then a couple months ago I started getting throbbing pain all down my arm and into my hand at night – which was really awful and would keep me awake for hours. Doctors and physical therapy and did nothing. Exercises and stretching would be of some help. But, it kept getting worse – even two weeks ago increasing. More major sleep deprivation and pain, and it got worse with even more limited motion. Then, two weeks ago an orthopedic surgeon told me to take organic liquid iodine. I was willing to try anything. I thought that sounds too simple. I got some organic liquid iodine from the local natural food store. It says to take one drop. I started taking seven to ten drops in water each day. Within a four days I would say there was a 25% improvement – and I was hoping that I wasn’t imagining it. Then another week of improvement and now there is what I would call a 75% improvement and I can now lift my arm straight up in the air, and can even lightly press my bicep on the side of my head with only limited pain. A week ago I could barely raise my bicep above my shoulder. I can’t yet reach my hand up my back all the way – but it is FAR better than it was a week ago when I couldn’t even get my hand above my back hip. A week ago pulling up my pants on my right side was far, FAR too painful to do and gave me that horrible pain. Now, I can do it without much pain at all. I’m amazed. Simple, low cost, easy cure. I wish someone had told me about taking liquid iodine five months ago. Last night was the first night I hardly had pain at night that woke me up. A few weeks ago I was waking up more than a dozen times per night in pain, and then was staying awake for a couple hours with the throbbing pressure type of pain all down my arm – which is now almost gone. I still get jolts of pain, but it is nothing like it was all summer, and even two weeks ago, and now it goes away quicker. Everyone who has frozen shoulder should be told to take liquid iodine. It’s a kelp extract.
That is amazing and I so wish someone would have told me about it. I spent 6 months in physical therapy for each shoulder. It was horrible pain as you have described and the therapy was just as bad. Thanks for spreading this information!
In the 4th edition of Dr. Ross Hauser’s book “Prolo Your Pain Away, Curing Chronic Pain With Porlothearpy, on page 96, he describes what Frozen Shoulder is and how Prolothearpy can help with the pain and healing of the shoulder.