Shoulder Pain: Rotator Cuff Vs Frozen Shoulder

Rotator cuff injuries are one of the most common causes of shoulder pain, but not the only cause. A condition known as the frozen shoulder is often mistaken for a rotator cuff problem because it can mimic the symptoms of rotator cuff injuries in its early stages. A rotator cuff is a group of muscles and tendons that surround the shoulder joint, and pain is caused by overuse or a direct injury. Frozen shoulder also called adhesive capsulitis, is caused by a stiffening of the shoulder capsule, the connective tissue that encases the bones, ligaments, and tendons of the shoulder. Over time, the shoulder becomes very hard to move.

Orthopedic specialists and other related physicians will be able to evaluate how limited the patient’s range of motion has become and take x-rays of the shoulder to determine what type of injury has occurred.  During a physical examination, your doctor will press on different parts of your shoulder and move your arm into different positions to determine the cause of your pain. If you have a rotator cuff injury, your range of motion may be limited by pain, but your doctor should be able to manually lift your arm. Frozen shoulder will restrict your range of motion, and neither you nor your physician will be physically capable of raising your arm past a certain point.

Rotator cuff injuries can stem from an inflammation of the joint or from a torn tendon. Inflammation can be treated with rest, physical therapy, and medication, while most cases of rotator cuff tears will require surgery. Frozen shoulder develops slowly, and passes through three stages as it resolves itself.

  • Freezing stage - any movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited.
  • Frozen stage - pain may begin to diminish during this stage. However, your shoulder becomes stiffer and using it becomes more difficult.
  • Thawing stage - the range of motion in your shoulder begins to improve.

Most frozen shoulder treatment involves controlling shoulder pain and preserving as much range of motion in the shoulder as possible through physical therapy, steroid injections, and medication. Fortunately, within our community, Cone Health Orthopedic Center of Excellence has an exceptional network of orthopedic and sports medicine specialists trained to diagnose and treat all types of shoulder injuries (surgically and non-surgically) and return patients to their normal lives and routines as quickly as possible.

Spokesperson Background:

Dr. Jesse Chandler is an orthopedic surgeon at Guilford Orthopaedic & Sports Medicine Center and a member of the Cone Health medical staff. Dr. Chandler received his Doctor of Medicine from the University of Pittsburgh School of Medicine in 2004. He completed his residency in orthopedic surgery at the UNC Department of Orthopaedics in 2009 and a fellowship in shoulder and elbow surgery at Rothman Institute in 2010.