Menopausal Frozen Shoulder

Bones, joints and muscles
1

Any ladies with frozen shoulder who are peri menopausal/menopausal and not on HRT should have a serious chat with a (preferably female) GP.

I suffered for ages (two male GP's dismissed the idea of it being hormonal) before being diagnosed with menopausal adhesive capsulitis by a Nurse Practitioner who researched the subject for her thesis. This is also sometimes known as menopausal tendonitis/arthritis. After a month of being on conjugated estrogen (Prempak C) it is like someone has 'oiled' my shoulder. I felt like I had completely seized up and my bicep and shoulder muscle were like concrete. I am now able to do gentle exercises to free the adhesion, and can now lift my arm (impossible for months) to wash and dry my hair/shave under arms etc. Estrogen is the WD40 of the body, and without it, in some women the soft connective tissue goes hard and brittle. Not all women suffer from joint/connective tissue problems in menopause,. but interesting it is usually the ladies who were a bit smug, because they got got to 50/55 ish with no real symptoms or hot flushes - then bam, being hit like a ton of bricks with frozen shoulder. I also had stiffness and pain in the other shoulder, other large joints, elbows and fingers. Mornings were terrible, it could take up to ten minutes to actually get OUT of bed, and sleep? Forget it, being woken with shoulder pain every half an hour.

HRT is not for everyone, but AC was ruining my life. Given that the prognosis for recovery can be up to seven years ...I decided the risk was worth it.

i would never EVER have thought that simple 'hormones' could cause so much pain and change me from being a fairly fit 50 year old into a crippled 90 year old.

Google menopausal frozen shoulder/menopausal tendonitis/arthritis and go and see your GP ladies!!

2

I was very interested to read this-in the past two years after experiencing none of the usual symptoms of the menopause, I have had to have two steroid injections for a frozen shoulder and I have had two for "tennis elbow", one of which did do the trick[ despite being excruciatingly painful] , the other having failed miserably.

I have limited movement in my shoulders and I find the tennis elbow, sore and tiring.

I had never thought of any hormonal connection, but it makes perfect sense.

Thank you.

Juno

3

I'm glad it helped Juno. I admit to being slightly evangelical about spreading the word...I simply cannot believe so many GP's do not immediately put two and two together when a woman of a 'certain age' presents with sudden onset joint /tendon pain/tennis elbow/frozen shoulder. ALL of these conditions, in woman who has never experienced joint problems should be considered as being caused by hormonal changes.

I genuinely thought I had some awful disease, from bone cancer, to motor neurone, to polymyalgia - because I could not believe my body could change so quickly and be so painful and debilitating.

Typically, women who go to the doctor with symptoms of pain and stiffness are tested for inflammatory conditions - and who actually have 'menopausal arthritis' - will test negative, and their bloods will show a very low ESR and CPR. This does not help, as the baffled GP will tend to then assume it is nerve pain...or all in the mind, or Fibromyalgia - and give a low dose amytriptilene, instead of HRT. I believe a lot of women with Fibro actually are suffering from low estrogen.

The first elderly male GP I saw was supposed to be the practice rheumatology expert...and he had never heard of this (and poo poooohed my tentative suggestion that it could be related to meno) yet the nurse practitioner two door down the hall knew all about it? Doesn't make sense to me. I feel I would have been crippled for years if I had not gone to see her.

I am told that I only need to take HRT for a few years, as at some stage the body naturally recognises it has gone through menopause, and adjusts into old age. (What an expression!!) Some women have a natural decline in estrogen and are not affected. It seems to be the the women who have the sudden decline in estrogen/ovarian failure at the end of perimenopause who seem to sufffer the worst, so suddenly and with such ferocity.

I also have a terrible elbow which constantly clicks and pops - so I sympathise with you there too.

Good luck

Lesley

4

Sorry - I forgot to add - if you google estrogen and joint pain, lots of information comes up. I also discovered that much younger women who have breast cancer are sometimes treated with with drugs to completely suppress estrogen. These women often complain of sudden onset joint and tendon problems and muscular adhesions soon after commencing treatment - which is so debilitating that a lot of them refuse to continue on it.

5

Hi

I've been following this post with interest. I've had frozen shoulder 3 times in last 20 years. However I'm not a woman...I'm one of the others ! So, please don't all morph into one giant woman and tear me to pieces. I can see that there is likely to be a greater incidence of frozen shoulder in women who have gone through hormonal changes, especially where osteo arthritis might be developing, and this is borne out with the number of postings on the web from women who are over fifty. However, my experiences with FS were seemingly caused by a neck problem I've had for a long time....cervical spondylosis ( age 40 to 55). Each time, although quite painful for a few months, it eventually cleared up after about 10 months and the shoulder returned to normal., without fail. Point I'm making is that there was nothing intrinsically wrong with the shoulder itself, the symptoms were referred muscle spasms from the neck problem. I'm wondering if this could be true for all cases of FS and , if so, I don't see why they should focus on the shoulder for applied treatments. I think its best left alone and not aggravated further in any way. Thus it might heal sooner than one which is continually exercised. I know the Physios etc like to be seen to be doing something positive, but really their interference might be extending the problem. If they were to say that the FS is likely to dissipate after 3 months and disappear after 10 months, on its own, then we could make the choice of whether to interfere or not. In my opinion, a condition which everyone accepts returns to normal with no resulting signs of wear or tear, should not be tested in ways which might leave more permanent damage.

Sorry to nudge in here on a valid argument on why women might be more susceptible to this condition. I just wanted to point out that the cause of FS may be more neck-based than shoulder based, and maybe treatments should be more concentrated appropriately.

6

HI

Well I'm very confused now. I thought lesley 998 was on to something as I am a 51 year old ( certainly on the change). I'm on my second frozenshoulder /adhesive capsulitis on my none dominant shoulder. I can see why the change in hormones could cause these problems, sounds very logical and something I will look into further. Then Gerry the neck throws a spanner in the works as I can relate to the neck problems having suffered on and off since 1999 with neck pain after disc removed and fused at C6, so could this be were my problems stem from?, yet another avenue to pursue. I had surery last year for frozen shoulder then within 8 weeks needed MUA as it became encapusalted. Now, just over a year on, the same shoulder is frozen again. According to the consultant this is unheard of. I know Gerry you would disagree with that.! I've also read that having too agressive physio is detrimental, infact my consultant has advised against it. I am worried about surgery I am going to have on my other shoulder at the same time as my MUA this is needed due to arthris , floating bone fragment and spur. I think I am going to end up with frozen shoulder again or encapsulitus. But I am hoping that there will be light at the end of the tunnel and after the surgery this time I will be pain free - eventually.

All your comments are very interesitng and food for thought

7

Hi Gerry - I absolutely agree with everything you've noted - and as I am no doctor or specialist - I have no more of a clue than anyone else! I posted because I was suddenly struck down by this awful painful condition, as are so many menopausal women - and yet no GP seems to recognise it as a symptom of menopause. It is not generally recognised, that sudden onset FS , or any tendon/arthritic issue in women of a certain age - with no previous neck or shoulder or musculoskeletal issues - could be caused by a sudden a reduction in estrogen which rapidly affects these tissues.

Of course this condition affects both sexes equally...as you know to your painful cost. Neck, spine, shoulder problems hormonal issues....who really knows why this condition appears in both men and young women, and menopausal women. But it seems the resulting constricture and debilitating long term shoulder pain is the same, whatever the etiology.

i was speaking to a lady last week about this who I met on another forum. She is 51, has breast cancer and has been on estrogen supressing drugs for six months. She has developed sudden onset severe pain and stiffness in both shoulders and also has problems with both elbow tendons. She is on the waiting list for a scan, and is terrified the cancer has spread to her bones because no one has offered any other idea why she is in so much pain. We both think the estrogen link is just too much of a coincidence and she feels much less concerned now she knows there could be a reason for this sudden condition after never having had so much as a neck twinge in her life.

Although replacing hormones does help as I first posted above - I have to admit I am still in quite a lot of pain with this one bad shoulder. Thankfully I no longer have pains in other joints, or hips and elbows as I did, and perhaps was lucky that hormone replacement halted any further issues. I am sadly coming to the conclusion that of course, nothing can actually 'cure' FS if hormonal loss is indeed the cause. It seems once the damage is done, and the scar tissue has adhered we are playing the same long waiting game as everyone else.

perhaps tabs....you have being dealt a double blow by being both hormonal, and already having had neck issues...I wish you the best in your journey.

8

Hi Lesley

I agree with you as well. Where women of a certain age start to experience frozen shoulder, there must be a connection to hormonal changes and oncoming osteoarthritis and the estrogen treatments look like the best preventative options in those circumstances. If your advice was heeded perhaps there would be less incidences of FS in that demographic. So, I support your advice. However, where FS has already occurred I think it would be wise to not exclude the neck as a possible cause....the reason being that any subsequent treatments applied to the shoulder might be counter productive. The logic works like this for me....If someone who doesn't have osteoarthritis or isn't experiencing hormonal changes, but still experiences FS, then you have to look for a common cause, something that might apply to both sets of circumstances, but is not only evident in one. So, where I'm advocating a neck based source, and you are advocating a lack of estrogen source, I'd be inclined to put both together and say they don't necessarilly conflict. I've had FS 3 times and I'll vouch that each time it totally disappeared after 10 months or so, with no residual damage. There was no actual fault in the shoulder. So, like you, I get a bit concerned when I read posts that advocate any kind of surgical intervention or strenuous exercises, because I think that could be creating problems for the future. I understand the frustrations that drive people to these treatments, but I think its only right to add a word of caution. Chances are it will self resolve sooner if left alone.

However, I totally agree that what you suggest might help with correcting the prime cause of why FS is so common in post menopausal cases. Sorry if I sound a bit like a medic...I'm not. I'm just very familiar with my own FS incidences. And I always knew it would be difficult to say my bit here, without crossing some lines. I think our intentions are the same but just aimed at different aspects.

Gerry

9

Hello again all! Been doing more research into this and have found some interesting sites regarding FS in Japan, where hot flushes are so unknown that there is not even a japanese word for it, but the number one symptom of menopause is frozen shoulder...known over there as 'Fifties Shoulder.'

I also found a site from a Vancouver based physio who states that the number one reason for developing frozen shoulder anywhere in the world is being...you guessed it, fifty and female!

I am not allowed to post the link, but if you are interested google Mike Dixon and Electra Health.

...and Garry, again...I know you men get this condition! But this specific thread was to highlight the connection between frozen shoulder and menopausal women.

10

Hello Lesley998 and others suffering from or who have suffered AC.

I am 55 years old and am just coming up to my one whole year without periods.

I was diagnosed with AC in my right shoulder about this time last year and sent to physiotherapy alongside taking Ibuprofen 400mg.

Whilst the Ibuprofen helped with the pain I was given the usual set of exercises to do (finger walk up wall and various other stretching exercises).

I can now say that the original AC has now resolved, no pain and I can at last lift my arm enough to shave my armpits, reach for things without going 'Owww' and no more of that horrible pain that feels similar to whacking your funny bone and everything has to stop until you can get your breath back again. ROM is not as good as before but perfectly acceptable.

Now I'm getting the same symptoms on the other shoulder. I'm so glad that one resolved before the other as I've heard of people getting "stereo frozen shoulder" which must be horrible.

I must say that I wasn't terribly diligent with the exercises after a couple of months or I would occasionally do the stretches if it was particularly bad but I can say that the condition does seem to resolve itself which I think is important to mention.

My GP was sympathetic and told me that it would resolve in time and he offered me intra-articular injections which he is experienced in giving but I declined as the results can be negligible.

For those with very bad AC and where lifestyle and work is seriously compromised there is MUA (manipulation under anaesthetic) but should only be done by experienced orthopaedic surgeons and sounds awful! The YouTube video of the procedure put me off, even though it was done under GA.

Another interesting treatment is pumping in sterile water and anti-inflammatory infusion into the joint to "re-oil" the joint and gently break the adhesions. This is done with the patient awake under local anaesthetic but is only practised by a few hospitals/consultants in the UK.

Totally agree that it's menopause related, I have 3 friends who are going through or been through "the change" and they have all had frozen shoulder at that time too.

I am not going to have HR as my doctors practice do not approve of it except in exceptional circumstances and the only other symptoms I have are hot flushes at night but there again I'm patiently waiting for this to subside and cuddle my "Chillow" instead! :D

11

Hi Fusspot....

I had my HRT increased to the highest dose as along with the FS in my left shoulder, I was starting to get worse symptoms in my right shoulder, my elbows, and was starting to get problems with my hips too. I was just about at my wits end. I have to say, I feel the benefit of HRT - having estrogen back again has made a huge difference to my joints and tendons and I truly believe it has turned me back into a 50 year old instead of a 90 year old cripple.

12

Hi everyone,

I am brand new to this forum and come out of total frustration. 5 years ago I had a terribly painful case of frozen shoulder. I had an MRI and an ultrasound which revealed a possibility I tore ever so slightly my rotator cuf. The examination was inconclusive but I got teh FS after moving a very heavy treadmill out one room down a hall and into another. i really over stressed the joint and thought I just had sore muscles. It took me 4 years to recover which included the shot in the shoulder twice and PT. I eventually gave up the PT as every time I went it set me back very painfully for at least 3 weeks. I was warned by the specialist that in most cases once having a FS you will get it some years later in the opposite shoulder. I dismissed this as ludicrous since mine was from a dumb injury. Well here I am 5 years later with a FS in my other shoulder! pooh! This one is different. Very painful yet not as excruciating as the first. I went to the Dr much earlier (last time I waited 3 months of trying to deal with the pain on my own) I did get the shot in teh shoulder but I can't tell it actually helped. I also got a two week batch of anti-inflamatory pills. They did help a bit but now that they are over I notice an increase in the burning and more pain. This one seems more inflamed. I can feel the burning all down the front of my shoulder and into my elbow. Sometimes even under the lower part of my shoulder blade. I am so frustrated because I can't ride my bike, open doors reach for things in the fridge, etc. sad

I have read the discussion here and am very interested in the idea of a hormonal thing. I am 50 and have had some mild menopausal symptoms since my early 40's. But how to bring this up to my Dr? I am living in the Netherlands and Dr's here tend to get rather disgruntled when patients try to tell them what to look into or how to treat you. Hormone Replacement Therapy? How would I know that this is something I should look into/need? Anyone know if I look forward to getting FS's every 5 years for the rest of my life? Or does it just go away after the two shoulders?

I am so sick of being in pain all the time especially when the first one only just got better (although I do not have the complete full range I used to have. I cannot wash my hair with two hands, style it, shave my pit blah blah. It's horrible. Any advise?

13

Hi MJT.

Well, since I last posted - my other shoulder is now stiffening up and I know I have two frozen shoulders. The movement is not as limited as in my left arm (my dominant shoulder) but the pain is just as bad. The other day I slipped on ice, and automatically my arms went out to try to balance..the pain was so bad I had to sit down on the kerb for a few moments till it passed as I thought I was going to be sick.

So, I now have about three inches of movement in the left arm, and not much more on the right. If it carries on, I seriously wont be able to reach back to wipe my own bum!! Sorry to be so rude, but anyone with this condition will know how restrictive your arm movements are. I can't tie an apron, pull up trousers, wash under either arm (without a sponge tied to a stick) I cant hang up washing, dry my hair or even lift my left arm high enough to put on my eye makeup. If i get an itchy back it is a disaster until I can either find a door frame to rub against like Baloo the bear, or my husband's hand to scratch it! I bought a back scratcher the other day in a joke shop - it is bliss smile

If I move in bed it is complete agony, I can't lie on either shoulder, and have to sleep on my back which is not natural for me. .

I KNOW this is all hormone related. I don't need a doctor to confirm it, and I know I am playing a wating came until my body comes out the other side. It MUST be self limiting, please God...and the body MUST get used to the decrease in estrogen, which is like the WD40 of the body. I just cannot bear the though of life with this forever. However, I have done a LOT of research on the internet (Japanese women get it all the time, and so do young women with breast cancer on estrogen supressants) and apparently you do come out of the other side when the body decides to!

I went on high strength HRT (Prempak C) as I just could not live with the pain. I do feel better on it. But, I realise that unfortunately, once you get a frozen shoulder as a direct result of menopausal (or other hormone deficient ) tendonitis, the frozen shoulder itself does not magically go away just because you take hormones...it will take however long it takes as it would with anyone who got it, male or female. The right thing to do would be to realise what is happening and take the HRT BEFORE the frozen shoulder sets in. Oh for a crystal ball, I would have taken it at the start of peri, five years ago.

The good new is that once you have had frozen shoulder you very rarely get it in the SAME shoulder again. So this means for you and me, the chances that it will keep recurring are slim. I am sort of glad I got them both at the same time as I would have been distraught if I had got over one FS, then had another, like you did. At least you also know the drill...four years for your first one....oh dear sad

If I were you I would try HRT. It really has softened things up a bit for me, and I am not in as much pain as I was. I used to take 5 x pain relief a day, but since starting Prempak I take nothing.

Good luck.

14

Hi Lesley998,

I cannot imagine two FS's at once. I am so glad to hear that the probability of getting this again is very slim. I simply could not go through this again. I understand teh back scratcer thing. I use a long plastic fork I got from a take out place that used fancy forks that look liek real ones. It's just long enough to do the trick.

I found a VERY interesting article here: http://www.frozenshoulder.ca/

I am Canadian but live in Europe. I am considering going back for a month just to do this treatment. One treatment and then home exercises I can deal with over choosing 4 or 5 years of pain! I contacted them via Email and they sent a form to fill in and will need the xrays and Dr's report.

In the mean time I will discuss with my Dr the HRT and see what he says.

Thanks for your help and good luck to you too! (still shaking my head over 2 FS at once!)

To Gerry the Neck, I have an old history of continual neck problems due to the type of sport I did in my younger years. So I suppose I get a double whammy here with neck shoulder upper back problems. None were very substantial with exception twice when I was only in my 20's and had a terrible tear in my upper back. I suppose age is catching up to all the sport injuries we do to our bodies when we were all young and foolish haha!

Everyone else: Take care, there IS a light at the end of the tunnel even when we find ourselves on the curbside as Lesley998 did. I did a similar thing, slipping on stairs and grabbed the handrail instinctively. I cried out, rather yelled out, and crouched squatted on the stairs for about 5 minutes before I could get up again.

So I diligently plug away at my very little arm swings, try to hug myself and hope for the best.

15

I developed a very frozen left shoulder almost exactly at 50 last Summer. I had no idea what it was. I tried to do as the doctors suggested physical therapy which made it worse !!! I am a nurse and not able to work very much at this time. I do some home stretches, pack my shoulder in ice, take small doses of ibuprofen, tylenol and neurontin which helps. It's hard not to be depressed and grouchy sometimes with my family.. Frozen shoulder is very disabling and I can't believe they really don't know how to treat it or prevent it.

I am interested in the HRT but I really not fond of the side effects. I am looking for a good alternative herbal hormone supplement.

I found your posts encouraging and helpful, bless you all.....breathe and relax.

16

As the original poster, just wanted to update on my situation for anyone who may be following this thread regarding sudden onset frozen shoulder in menopausal women.

In late January this year after months of constant pain in both shoulders, I suddenly realised (literally over a matter of days) that I had less pain and more movement in both my arms. I was beginning to un freeeze. I still did not have anything like full movement back in my left arm, but I had not had one of those killer spasms since Christmas. Hallelujah I thought, it is over.

Whether this was due to taking high dose HRT for a month, or a natural event that would have occurred In this self limiting condition who knows ...but , here's the thing.

Unfortunately, due to sudden severe migraines for the first time at age 51 - along with some other horrible side effects including sky high blood pressure - I was recently taken off HRT by my GP. (I was on Prempak-C 1.25)

Two weeks after taking my last HRT tablet I began to feel that tell tale tendon pain in my shoulders and elbows. I now have familiar pain in my left bicep and collar bone. It is following a patterns I am only too familiar with from last time and I fear I am on my way to another FS. Or two. Who knows.

What people without this condition do not realise is the extent of how much it changes your life. Everything is geared toward not causing yourself ecrutiating pain. You cannot raise your arm past a certain level, so how you dress, sleep and live is drastically changed. it is like living with your arm in a constant sling.

I know men and women get this condition and it is not limited to being linked to hormonal activity, but in my case, it most definitely IS linked to hormones and estrogen depletion and I am thoroughly p*issed off!!

17

Hi there

Just reading your discussions and just thougt I'd let you know my situation.

I'm 50 years of age and up to a frozen shoulder taking over my right arm 10 months ago I was very fit, kick boxing up to 4 times a week. My husband still has his frozen shoulder in his left arm since last July and thought I was just copying him. But it turns out I do have genuine frozen shoulder and torn tendons in my right arm

The surgeon recommends physio for 6 months to try and free it up the arm before I can have the opp.

I'm on a load of pain killers which quite honestly don't help any.

I can't sleep in any position and to be honest I'm turning into a bear with a sore head. Grumpy draws is my nick name now.

Which is likely to be causing me the most stress. The frozen shoulder or the torn tendons?

I just know don't anymore. I can't think striaght, or compose a letter to save my life. I sew for a living so everthing in my life is affected. Not a happy bunny I'm not.

Interesting reading your discussions though and I'm off to see the doc again tomorrow and will discuss the menopause with her. I'm useless at taking any medication, you could say I'm a complete lightweight.

Cheers

Sharon

18

Hi Sharon1692

I really I am also 50 but got my first FZ in my mid/late 40's. My 1st FS I was truly convinced I had just simply torn something and would not listen to any DR whom said maybe I tore my rotator cuf but the evidence was inconclusive. My FS started after I moved my very big treadmill out of one room down a hall and into another room by myself. I'm 5'+ and so when the next day I had muscle pain I chalked it up to just doing too much. 4+ years later I knew better! Now I'm on my second FS which coincidentally has started around the very same moth my original one started all those years ago? Hormone cycle? could be. I also did show the beginnings of menopause quite early. I already had hot flushes as early as 41.

Just an update on the link I posted earlier. I chickened out and did not book an appointment. I spoke to my Dr and he was skeptical saying every few years a new fad cure or surgery comes out. he advised me to wait. Now I am not in any constant pain, unless I move my arm past it's allowed point by accident. Then I scream bloody murder. I have had now two cortisone shots. I know the cortisone risks but when you are in constant excruciating pain you are willing to do just about anything. The risk si far milder than surgery or even HRT. I am not a candidate for HRT (but that is not a Dr's opinion. I've not really spoken to my Dr about this). My hot flashes have become quite bad recently though. So the time may be approaching.

BUT. If it I find out from ANYONE that after two FS they got yet a 3rd I am going to take every possible therapy known to man! I just cannot go through this a third time! Now I have done both arms and what's next, a leg? haha!

To all you that are in the first few months stage of FS, I really get your pain. You think it will never end. You can't wash your hair, do the dishes, hug your partner, kids, dog. That stage does end! You sneeze and end up with tears in your eyes 'cause your arm moved. You go to reach that bowl on the top shelf of your cupboard and yelp in pain cause you forgot and reached with the wrong arm. Try whatever therapy works for you. Cortisone, HRT, Physio. Each of us respond differently.

BTW, Sharon, I take turmeric and ginger capsules every day. You can get them and any natural health store and often combined. Both help with inflammation and turmeric will help ease your stomach from all the pain killers you pop just to survive. They won't help much in the really bad first stage, but I live by them right now cause I am REALLY bad with taking pills. You can get both Ginger and Turmeric in gel capsules so easy to swallow.

19

Sharon...not a candidate for HRT?

Hot flashes? Aged 50? You may not want to *HAVE* HRT...but I think you are definitely a candidate at age 50. it is definitely menopause...we can't escape it, taxes or death!!

20

Whoops, the above reply was meant for MJTh!

Must be my menopausal eyesight ....