Life can suddenly change for women who develop a frozen shoulder. It is often referred to as the “silent thief of motion” as seemingly mundane tasks of fastening a bra strap, reaching for a book on a high shelf, drying clothes on a ceiling clothesline or even unscrewing a jar can cause agony when the arm is frozen in place.
Frozen shoulder, as the name suggests, is characterised by a gradual loss of joint mobility accompanied by pain and stiffness. The resulting inflammation causes a further reduction in the range of motion over time (typically external rotation), eventually leading to that “frozen” feeling.
Adhesive capsulitis (the technical term for frozen shoulder) is an unfortunate reality for many women during perimenopause and menopause. Some people are more prone to it than others: those with diabetes, for example, and people of Asian descent.
In fact, it is so common among Asians that it is often known as the “fifties shoulder” or “fifty-year shoulder".
Knowing more about this condition is the first step towards managing it effectively. Here’s all you need to know about the impact of a frozen shoulder in menopause and strategies to prevent and combat it.
What causes frozen shoulder(s) in perimenopause?
The scientific link is not firmly established, but it is thought to be related to the hormonal fluctuations during perimenopause and menopause. Additionally, poor sleep, depression, fatigue, etc. can further exacerbate inflammation and joint stiffness in those who already have this condition.
How do perimenopausal symptoms increase the risk of frozen shoulders?
Declining estrogen. Estrogen plays a crucial role in bone and joint health. In fact, studies show that estrogen deficiency affects joint tissues including the synovial lining and capsules (lubricating structures surrounding the joints), muscles and ligaments. This could very well impact the shoulder joint capsule thereby making it stiffer and less elastic, and increasing the risk of developing a frozen shoulder.
Sleep disturbances. Hot flashes and night sweats can disrupt sleep patterns, leading to fatigue and impacting regular physical activity contributing to stiffness. Additionally, lack of sleep also impairs the body's ability to repair and regenerate tissues, including those of the shoulder joint.
Muscle weakness. Hormonal imbalances also directly and indirectly affect muscle strength and coordination, which weakens a woman’s ability to maintain proper posture and flexibility. One of the major joints affected in this process is the shoulder joint.
Psychological Factors. It is a well-known fact that mental health can contribute to muscle tension and pain. Mood swings, anxiety, depression and other psychological factors that are common in menopause can hasten the progression of shoulder pain symptoms eventually leading to a frozen shoulder.
Is it curable?
Yes, it is. But it can be a long-drawn process that can take months or even years. Preventing it altogether or managing the pain is an easier task and most lifestyle changes typically focus on this.
A 2023 retrospective study of 1,952 female patients between 45 and 60 years of age revealed that those who didn’t use hormone therapy had a 99% greater chance of receiving a frozen shoulder diagnosis as compared to those who did; indicating that hormone therapy may be a promising cure. However, more expansive research is needed to confirm this.
What are the lifestyle changes I can make to manage this condition?
Movement and Physical Therapy. This is the foundational treatment for a frozen shoulder. Dynamic movements such as swimming, dancing and weight-bearing exercises when done regularly can help prevent this condition. For treatment, a personalized set of exercises designed by a physiotherapist and targeted at improving range of motion, strength, and flexibility can make a difference. In fact, a controlled trial of 62 perimenopausal women with diabetic frozen shoulders revealed an improvement in pain intensity, disability level, shoulder flexion, abduction and external rotation range of motion with physical therapy in just 4 weeks.
Posture Correction. This is especially important in the modern lifestyle where women are constantly hunched over their phones or laptops, thereby increasing stress on the shoulder joint. Consciously focusing on good posture, investing in ergonomic furniture and performing posture improvement exercises regularly are needed to combat this.
Pain Relief. Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain, which is the top reason for people missing out on their physical therapy protocols. Even creams and gels containing menthol or capsaicin can provide localised relief. Stronger treatment options, such as corticosteroid injections directly into the shoulder joint, can reduce inflammation as well as pain.
Supporting Therapeutic Modalities. Heat therapy, ice therapy, massages and ultrasound are some other ways to manage pain and inflammation and enable women to adhere to physical therapy. Heat packs are used to relax muscles and reduce pain, whereas cold packs can numb the area and reduce inflammation. Sports massages, especially before physical activity, can improve circulation and the range of motion more effectively.
Sleep & Stress Management: Maintaining a regular sleep schedule and adopting stress management techniques like meditation or deep breathing can help alleviate sleep disturbances and promote tissue healing and recovery.
Are there any specific nutrients that can help with inflammation and healing?
Yes, there are. The role of certain nutrients in supporting overall joint health and reducing inflammation is well established and these could potentially benefit those with frozen shoulders too.
1. Omega-3 Fatty Acids. These are commonly found in fish, flaxseeds, sea algae and walnuts and are well-established as anti-inflammatory agents.
2. Curcumin. It is the active compound in turmeric and has potent anti-inflammatory and antioxidant properties. It can be consumed with milk or honey, or added to vegetables and dishes, as commonly done in Indian cooking.
3. Vitamin D. Although not easily found in foods, vitamin D is not a hard nutrient to get, as long as you expose yourself to sunlight most days of the week. It has a proven role in calcium absorption and musculoskeletal health.
4. Magnesium. It naturally occurs in whole grains, legumes, dark green leafy vegetables, and pumpkin seeds. It plays a role in relieving muscle tension and spasms and promoting nerve function.
Summary
While the exact relationship between perimenopause/menopause and frozen shoulders is not fully understood, there is a strong association between the two. Management strategies are effective, but patience is key when dealing with a frozen shoulder as it may take several months for symptoms to improve. Combining good nutrition with regular physical therapy and professional guidance can help regain full shoulder function.
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About the author
Kanchana is a Lifestyle Consultant & Weight Management Specialist. After a Masters degree in Molecular Biology from the USA, she ventured into the field of Nutrition and is certified in General Nutrition, Sports Nutrition, and Weight Management. Her own successful weight loss journey inspired her to help people of all age groups and health conditions via Calorie Culture, which she founded in 2012. She is also an avid dancer, mini marathoner, and sports enthusiast. She strongly advocates sustainable lifestyle changes as a means to long-term health benefits and optimal weight.
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