I Was Diagnosed With Frozen Shoulder If You Re A Woman You Could Be Too

I woke one morning in early December 2010 with a throbbing ache in my right shoulder. Unlike my other midlife sprains and pains, it got worse. I began marking time with doses of ibuprofen, noting—with alarm—how my stiff arm could barely reach the medicine cabinet. An orthopedist ordered an x-ray. “You might have a small tear in your rotator cuff,” he said and sent me home with a script for eight weeks of physical therapy. The aggressive physical therapy sessions (conducted by a well-intentioned but, in retrospect, inexperienced therapist) were excruciating but I stuck with it. Without sleep I was breaking down. I started washing my ibuprofen down with red wine. When I tried to move my arm out of an increasingly narrow range of motion, it felt like someone was jabbing me with a kitchen knife. I was up to eight ibuprofens a day. My stomach was not amused. After six weeks of this torture, an MRI (I had to plead) finally revealed a diagnosis unseen in the x-ray: Adhesive Capsulitis (AC), or “frozen shoulder,” a spontaneous inflammation of the capsule tissue surrounding the joint where the collarbone, scapula, and upper arm bone meet. You’ve probably never heard of AC, unless you or someone you know has endured it. The medical community still doesn’t have a full understanding about what causes it. That’s not for lack of cases. Statistics vary from 2% to as high as 5% of the general population. It affects more women than men, as well as people with diabetes and thyroid conditions. And it can run in families. After my diagnosis, I remembered that my brother had had shoulder pain several years earlier, as had my mother before him. He sent me to his physiatrist where I finally found relief. Vijay Vad, M.D. at the Hospital for Special Surgery in New York City explained that left untreated, the capsule becomes inflamed, then frozen and scarred, before finally “thawing” on its own. The process can last months, even years, before resolving as mysteriously as it begins. As David M. Dines, MD, (an orthopedic shoulder surgeon at HSS) says, “Adhesive Capsulitis is an enigmatic and bad-ass disease.” I’ll admit that it was just a little cool that anything about my ordeal could be called bad-ass. Frozen shoulder moves through four stages: inflammation, freezing, frozen, and thawing. Getting the disease resolved quickly depends on matching available treatments to your stage. In the early stages, sonogram-guided cortisone shots will often be enough. In the frozen period, when the tissue becomes rock hard and the shoulder is completely immobile, surgery is often recommended. I was in late Stage 2 and for this Dr. Vad proposed a capsule distension procedure. Unfortunately, you may have trouble finding a doctor who can perform this procedure for you. Capsule distention isn’t covered by many insurance plans and therefore many doctors don’t want to do it. In this minimally invasive procedure, the physician, using a sonogram as a guide, injects saline solution into the joint capsule to expand and then flush or “lavage” it, and then injects cortisone and other pain relievers. I won’t lie—even with a sweet sedative this was no fun, but in 15 minutes it was over. Within days the pain backed off. I spent a full year in PT rehabilitating my shoulder. Dr. Michael Zazzali, my new physical therapist, has had many years of experience with shoulder issues and his approach was completely different. Recovery was slow but steady, without the intense pain of the first physical therapy sessions. I am delighted that I can now do cobra pose in yoga class, though my days of headstands and “broken in eight places” might be over. Two years later, when pain started in the other shoulder (yes, if you’ve had it on one side, you have a 50% chance of recurrence on the other side!), I went straight to Dr. Vad for a cortisone shot and that was the end of it. I’ve become a bit of health nut since that first episode. Our kitchen is piled high in kale. I drink a pot of green tea a day. I take Omega oils and every morning my boyfriend makes a berry smoothie. I eat oatmeal and avoid bread pasta, and sugar. I eat lean meat and not that much. I still eat chocolate daily because without that life isn’t worth living. I feel better and stronger since I altered my diet. “The things to avoid are fatty meats and processed sugar,” says Dr. Vad. “Absolutely the enemy because they really increase inflammation. The three supplements that can really help reduce inflammation for my patients are: Omega 3 (fish oil), Vitamin D, and the spice turmeric.” While there is still no cure right now for AC, Dr. Vad and Dr. Dines both look to ongoing research into the use of collagenase, enzymes that break the peptide bonds in collagen, the main component of connective tissue. “I believe Collagenase injections will become the future treatment for frozen shoulder,” forecasts Dr. Vad. Let’s hope so. Julie Metz is the author of the New York Times bestselling memoir Perfection (Hyperion, 2009). It was a 2009 Barnes & Noble Discover Great New Writers Selection, has been translated into six languages, and was featured on “The Oprah Winfrey Show.” The recipient of a MacDowell fellowship, Julie has written for publications including The New York Times, Huffington Post, Publishers Weekly, Glamour, Coastal Living, Prevention, Family Circle, Redbook, and websites such as Wowowow.com (The Women on the Web), Family.com, and the story site mrbellersneighborhood.com. A recent essay titled “Instruction” was included in the anthology The Moment (HarperCollins, 2012), edited by the creators of Six Word Memoirs. You can find out more about her work at www.juliemetz.com