Frozen Shoulder in Menopause: Causes, Treatments, and Exercises for Relief

All-too-familiar symptoms of menopause: hot flashes, mood swings, and insomnia. But frozen shoulder? That’s a bit of a surprise. Frozen shoulder makes your shoulder stiff, painful, and hard to move. It often affects women between 40 and 60 years old, which is right in the menopause age range. While there's no direct link between menopause and frozen shoulder, experts think the hormonal changes during this time might increase your risk. 

Here, learn more about what causes frozen shoulder during menopause, and how to prevent and treat it — especially with exercises from our Hinge Health physical therapists.

What Is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is an inflammatory condition that limits movement in your shoulder joint. Pain and stiffness come on gradually, and often get worse before getting better. 

Your shoulder is a ball-and-socket joint surrounded by a strong, connective tissue called the shoulder capsule. With frozen shoulder, the capsule becomes thick and tight, making it difficult to move. Bands of scar tissue (adhesions) can form and there’s less joint fluid to keep the joint lubricated. This makes it hard to move your shoulder, making it feel “frozen” in place.

What Causes Frozen Shoulder in Menopause?

There’s no evidence directly linking frozen shoulder to menopause. However, menopause involves hormone changes — specifically lower levels of estrogen, which may contribute to frozen shoulder.

Estrogen is a sex hormone that affects many body systems, including your musculoskeletal system. It helps maintain bone structure and improves muscle strength. Estrogen also increases the collagen content of connective tissues in your joints. Research shows estrogen can decrease stiffness in muscles and connective tissue, and plays a part in preventing inflammation.

Enter perimenopause — the time leading up to menopause. (Menopause officially means that it’s been a year since your last period.) Perimenopause usually begins in the mid-to-late 40s and lasts an average of four years. During this transition, hormone levels fluctuate and estrogen drops. With lower levels of estrogen, inflammation may occur more easily. Plus, cartilage and other joint tissues lose some of their protection, which can lead to stiffness, friction, and joint pain. Together, the joint and muscle changes and symptoms associated with the loss of estrogen are known as musculoskeletal syndrome of menopause. 

Menopause may indirectly contribute to frozen shoulder in other ways, says Heidi Austin, PT, DPT, a pelvic health physical therapist at Hinge Health. Menopause increases the risk of insomnia and depression, which may raise your risk for developing shoulder conditions, like frozen shoulder, or make symptoms of pain and stiffness worse.  

Other factors that may increase the risk of developing frozen shoulder include:

• Diabetes

• Prolonged immobility, such as due to an injury or surgery

• Other medical conditions, including thyroid or other hormone disorders, Parkinson’s disease, or heart disease

Symptoms of Frozen Shoulder in Menopause

Signs of frozen shoulder include:

• Pain that worsens at night, with no known injury

• Decreased range of motion

• Dull or aching shoulder pain

• Stiffness that worsens over time

• Difficulty moving your arm, both on your own (active movement) and when using your other arm to lift it (passive movement)

Frozen shoulder typically develops gradually in three stages, according to the American Academy of Orthopedic Surgeons:

Stage 1: Freezing

In this stage, pain develops slowly and intensifies, especially at night. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts anywhere from 2 to 9 months.

Stage 2: Frozen

Pain might lessen during this stage, but your shoulder becomes stiffer. Shoulder use during daily activities may be very difficult. This stage typically lasts 4 to 6 months.

Stage 3: Thawing

Shoulder motion slowly improves. Regaining mobility and strength in your shoulder can take anywhere from 6 months to 2 years. 

Physical Therapy for Frozen Shoulder in Menopause

Frozen shoulder symptoms generally improve over time. The aim of treatment is to decrease pain and increase range of motion. In most cases, it starts with shoulder physical therapy. The more you can stretch and strengthen your shoulder joint, the faster you’ll regain mobility and be able to get back to activities you love. 

While you can exercise on your own to ease menopause-related joint pain, working with a physical therapist (PT) for frozen shoulder can be important. A PT can do a full assessment and tailor a comprehensive treatment plan to help manage pain and restore range of motion, depending on which state of frozen shoulder you are in, explains Dr. Austin. 

In the freezing (painful) stage, your treatment plan may include gentle stretching for only a few seconds at a time. In the frozen stage, a PT may add exercises to help maintain muscle strength. And in the thawing stage, stretching and strengthening exercises can gradually increase in intensity.

“Frozen shoulder typically follows a progression and can get worse before it gets better, so pushing through pain isn't the best approach,” says Dr. Austin. Instead, listen to your body and aim for a comfortable range of motion when performing exercises.

You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

Incorporating these exercises into your routine can help gradually restore shoulder function and reduce the symptoms of a frozen shoulder. A physical therapist can guide you in performing these exercises safely and effectively.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

More Ways to Treat Frozen Shoulder in Menopause

Physical therapy and exercise can be very effective for most people with frozen shoulder. But if your symptoms persist or become severe, your provider may suggest other treatments to find relief, including:

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for frozen shoulder pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Steroid injections. Injecting corticosteroids into the shoulder can help reduce pain and improve mobility, especially if done early when symptoms begin.

• Hydrodilatation. Fluid is injected into the shoulder joint to expand and stretch the joint capsule. 

• Shoulder manipulation. This procedure is performed under general anesthesia. Your doctor moves your shoulder in different directions to loosen tight tissue and improve your range of motion.

• Surgery. Surgery for frozen shoulder is uncommon, but if your symptoms don’t improve with physical therapy or other treatments, your provider might suggest surgery to release the scar tissue in the joint capsule. 

Tips to Prevent Menopause-Related Frozen Shoulder

Regular physical activity is key to reduce joint pain and stiffness during menopause. In addition to exercise, many lifestyle changes and other treatment options may help ease achy joints and prevent them from getting worse.

Eat more anti-inflammatory foods

Diet alone can’t cure joint pain. But eating well-balanced meals that include anti-inflammatory foods can play an important role in your management plan. Foods and nutrients that can help reduce inflammation include:

• Fruits (strawberries, blueberries, and oranges)

• Green, leafy vegetables (spinach, kale)

• Fatty fish (salmon and tuna)

• Healthy fats (olive oil)

• Nuts (almonds and walnuts) 

Take steps to reduce stress

Stress may make menopausal shoulder pain worse. Deep breathing, meditation and yoga, or walking can help keep stress levels in check. A bonus: Mind-body relaxation techniques have also been shown to help relieve the severity and frequency of hot flashes during perimenopause and menopause. 

Practice good sleep hygiene

Stay consistent with your sleep and wake times. Limit screen time in the evening and avoid caffeine before bed to help promote better sleep. Good sleep can help decrease fatigue and improve your mood, which can alleviate other common menopause symptoms that may impact pain.  

Consider menopause hormone therapy (MHT)

Does estrogen help frozen shoulder? Hormone treatment may help reduce joint pain during perimenopause and menopause. A recent study found that postmenopausal women who received menopause hormone therapy (MHT) were less likely to get frozen shoulder compared to those who didn’t receive it. There are many different types of MHT available. Talk to your healthcare provider to determine if MHT is right for you.

PT Tip: Think Holistically 

“Fixing a frozen shoulder can be challenging, but considering factors like hormones, diet, stress, medications, and sleep can make a big difference,” says Dr. Austin. “If you're struggling, finding a provider who understands both the orthopedic and hormonal aspects can really help.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.  

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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