Frozen Shoulder: Why Women in Their 40s to 60s Are More Vulnerable

Waking up one day and realizing you can’t lift your arm to brush your hair, this sounds like a nightmare. Frozen shoulder, also known as adhesive capsulitis, is a painful and limiting condition that affects shoulder movement. It develops gradually, making simple tasks like reaching for an object or lifting an arm difficult. While anyone can develop adhesive capsulitis, women aged 40-60 are at a much higher risk.

This condition is linked to several factors, including hormonal changes, underlying health conditions, and genetics. Understanding these risks and learning about prevention and treatment options can help women maintain healthy shoulder function as they age.

What is Frozen Shoulder?

Adhesive capsulitis is a condition where the shoulder joint becomes stiff and painful due to inflammation and thickening of the capsule surrounding it. This results in restricted movement and, in severe cases, can make it nearly impossible to lift the arm.

The condition progresses in three stages:

  1. Freezing Stage (2-9 months):
    • Shoulder pain gradually increases.
    • Stiffness worsens over time.
    • Pain is often more severe at night, making sleep difficult.
  2. Frozen Stage (4-12 months):
    • Pain starts to decrease, but stiffness becomes more severe.
    • Movement is significantly restricted, even when assisted.
  3. Thawing Stage (6 months - 2 years):
    • Shoulder movement slowly improves.
    • Pain continues to fade.
    • Most people regain full function, but some may not completely recover.

Understanding these stages helps in identifying adhesive capsulitis early and seeking appropriate treatment.

Why Women Aged 40-60 Are at Higher Risk

  1. Menopause and Hormonal Changes

    Estrogen plays a crucial role in maintaining joint and connective tissue health. As women enter menopause, estrogen levels drop, which can lead to increased inflammation and stiffness in the joints. Studies have shown that postmenopausal women are more likely to develop adhesive capsulitis, suggesting that hormonal imbalances contribute to the condition.

  2. Underlying Health Conditions

    Women in this age group are more likely to have conditions such as:

    • Diabetes – Research indicates that up to 20% of people with diabetes will develop adhesive capsulitis. High blood sugar levels can lead to chronic inflammation and thickening of the joint capsule.
    • Thyroid disorders – Both hyperthyroidism and hypothyroidism have been linked to increased stiffness in joints.
    • Autoimmune diseases – Conditions like rheumatoid arthritis can cause inflammation in the shoulder joint, leading to adhesive capsulitis.
  3. Genetic Factors

    A family history of adhesive capsulitis increases the risk of developing it. Certain genes influence collagen production, which affects how flexible or stiff the connective tissues in the shoulder are. Studies suggest that individuals with a genetic predisposition may experience an abnormal healing response, leading to excessive scar tissue formation and joint stiffness.

  4. Lifestyle and Activity Levels

    A sedentary lifestyle can contribute to adhesive capsulitis. Women who spend long hours at a desk or perform repetitive movements without stretching may develop stiffness over time. Lack of regular exercise weakens the muscles around the shoulder, making it more prone to injury and inflammation.

  5. Post-Surgical or Injury-Related Factors

    Women recovering from surgeries, such as mastectomies, or injuries that require shoulder immobilization are at a higher risk. When the shoulder is not used for a long time, the joint capsule tightens, leading to adhesive capsulitis.

  6. Higher Pain Sensitivity and Delayed Diagnosis

    Studies suggest that women may have a higher pain sensitivity than men. However, many delay seeking medical attention, thinking the stiffness and discomfort will resolve on their own. This delay can lead to worsening symptoms and a longer recovery period.

Can Men Develop Frozen Shoulder?

While adhesive capsulitis is more common in women, men can also develop it. Risk factors for men include:

  • Being over 40 years old.
  • Having diabetes or metabolic disorders.
  • Shoulder injuries from sports or repetitive strain.

Although men generally have stronger shoulder muscles, they may not seek treatment early, which can lead to prolonged stiffness and pain.

Diagnosis of Frozen Shoulder

Diagnosing adhesive capsulitis is primarily based on clinical symptoms. Dr. Suresh George explains, “A hallmark sign of frozen shoulder is loss of passive range of motion.” This means that even if a doctor tries to move the shoulder, it remains stiff and difficult to manipulate.

Imaging tests such as X-rays and MRIs are often used to rule out other conditions like arthritis or tendon injuries. However, these tests do not directly diagnose adhesive capsulitis. The progressive pain and stiffness over time are key indicators of the condition.

Prevention and Management Strategies

Preventing adhesive capsulitis involves maintaining good shoulder mobility and overall joint health. Here are some effective strategies:

  1. Regular Shoulder Exercises
    • Stretching and strengthening exercises can keep the joint flexible.
    • Simple movements like shoulder rolls and arm lifts can prevent stiffness.
  2. Healthy Diet with Omega-3s
    • Fish oil is known to reduce inflammation in the joints.
    • Studies show that omega-3 fatty acids in fish oil help improve joint mobility.
  3. Early Treatment for Shoulder Pain
    • Seeking medical attention for persistent shoulder pain can prevent adhesive capsulitis from worsening.
  4. Managing Underlying Conditions
    • Controlling diabetes and thyroid disorders can lower the risk of developing adhesive capsulitis.
  5. Supplementing with Omega-3s
    • Consuming fish oil regularly may help reduce inflammation in the shoulder joint.
    • Research suggests that people who take fish oil have better joint flexibility.

Will Frozen Shoulder Return?

In most cases, adhesive capsulitis does not return in the same shoulder once it has healed. However, people with diabetes, thyroid disorders, or a history of joint issues may develop it in the opposite shoulder later in life.

To reduce the chances of recurrence:

  • Keep the shoulder active with regular stretching.
  • Maintain a healthy diet rich in fish oil to support joint health.
  • Manage medical conditions that contribute to inflammation.

During the frozen stage of adhesive capsulitis, the shoulder capsule thickens, leading to decreased movement. Omega-3s in fish oil promote collagen production and tissue repair, helping restore the flexibility of the joint capsule over time.

Conclusion

Women aged 40-60 are at a higher risk of developing adhesive capsulitis due to hormonal changes, underlying health conditions, and genetic factors. Early diagnosis and preventive measures, such as regular exercise and consuming fish oil, can help maintain shoulder health.

If shoulder pain and stiffness persist, seeking medical attention is essential for early intervention. With the right approach, most people recover fully and regain mobility, ensuring they can continue with daily activities without discomfort.