Diabetic Frozen Shoulder

Hi Everyone,

After 28yrs with T1 and moving from 6 injections a day o my lovable pump I’m developing diabetic frozen should.
I’ve seen a response by Lee Ann to an RA problem but has anyone else developed this very painful condition? I have now seen a: shoulder specialist, physiotherapist and chiropractor and none of them can offer any help. It started about 6 months ago: for some reason I noticed while having a shower that it hurt when I put my left hand on my back which was strange to me. I used to be able to close my hands behind my back in a handshake like position without a problem.
Anyway the pain began to get worse and worse over time so I went to see a physio, they suggested some exercises and massage and that did help to start with. The movement in my shoulder became more and more restricted so I went to see my doctor and was refereed to a shoulder specialist. After x-rays and ultra sound he diagnosed me with having the first signs of diabetic frozen shoulder. Since seeing him I have also seen a chiropractor in an attempt to seek relief of the pain and in the hope he was wrong. Last night the chiropractor advised that there was no point in paying him 50 bucks every week when he cant actually resolve the problem.

So I’m here seeking if anyone has been able to find some relief, had this condition and found anything that helps. I dont want to keep taking pain killers.

Steve,

I am headed to a Orthopedic specialist on July 5th for what appears to be similar ailment. They ruled out rotator cuff, tedontitis, and bone issues with x-rays. I usually sleep for 3 hours a time. Yours is a new diagnosis to me. I have been a T1 for 35 years. I’ll let you know what I find out - I am ready for cure even if surgical.

The frozen shoulder could be related to diabetes. But I know three non diabetic women who have developed a frozen shoulder in the last three years (no family relations between them).

The biggest problem seems to be that the inflammatory process in the shoulder is causing the shoulder cap to get very tight. This tightness leads to less blood flow and less blood flow fuels the inflammatory process. So the condition gets worse over time.

Two of the women I know had intense physiotherapy over 1/2 to 1 year. Still one had to have surgery because the inflammation damaged the rotary muscle ring of the shoulder.The women without therapy recovered over three years from this condition but she still has pain when specific movements are involved.

In general I would say that it takes a whole lot longer than you already think. Intense physiotherapy is a good advise. But in my opinion if it is really painfull I would ask the shoulder specialist for a surgery. The shoulder cap could be (I dont know the exact medical term) grated to relief the tightness and to stop the inflammation.

I have had two different frozen shoulders and have done some research about them.

It turns out that you can have intensive, painful physical therapy and expect them to start to clear up in about six months or you can do absolutely nothing and expect them to clear up in about six months.

My own experience was that that very painful phase lasted about 6 weeks. The second one I got was especially painful as it trapped a nerve and I was in pain all the time. My doctor prescribed heavy duty pain pills which helped with sleep. I even went to an orthopedic surgeon who told me that it was one of the most inflammed frozen shoulders he had ever seen and that he could not operate on it because I could not have done the rehab.

But it got completely better over time!

Oddly both of my frozen shoulders occurred a few months AFTER I had made significant improvements in my blood sugar control. The first followed my initial diagnosis–I have a genetic form of diabetes where my blood sugar had been pre-diabetic since I was first tested 30 years ago, and the frozen shoulder started after I dropped it dramatically with a long term very low carb diet.

The second one followed in the year after I started using insulin at meal times and dropped my post-meal two hour numbers from over 140 to 100-ish.

I found that acupuncture was very helpful with my first frozen shoulder, but not in the acute inflammatory phase. That shoulder got very immobile after 6 months, and two acupuncture treatments freed it right up. But the acupuncture did not do anything for the acute inflammation in the second. The acupuncturist said that my muscles had gone into spasm in response to the previous inflammation which is why the treatment worked.

Finally, I let a doctor talk me into a cortisone shot on the first one. It did terrible things to my blood sugar and nothing for the shoulder.

Hang in there. Frozen shoulder almost always resolves on its own. If you are having pain ask the doctor for a prescription strength pain/inflammation drug. I can’t take NSAIDS but if you can, they should help, too.

I have been a T2 diabetic for 9 years and last spring developed frozen shoulder. However, they took x rays and an mri first and determined that I had a small tear in my rotator cuff. I hadn’t remembered having any kind of injury, but they said it could be caused by making repetative movements, which I did do. So, having the tear was painful which caused me to baby that shoulder, and that in turn froze it. They sent me to physical therapy and said this would be a process of no pain, no gain. I went for about 3 months, 3 days a week. Progress was slow but steady, and not as painful as I thought it would be. I can’t say that I’m 100 percent better but I can reach behind my back and grab my other hand, I can raise my hand all the way up and sideways without too much pain. Putting heat in the armpit and over the shoulder helped a lot for pain, and doing that just before therapy was a great help. I still have the tear which is less painful as well. Not painful enough to go through surgery to fix it and then go to more therapy to keep it loose. They told me about diabetic frozen shoulder and said that no matter what causes frozen shoulder, long stints of physical therapy work best. There is a very painful surgery out there to fix it as well. My brother-in-law had it done and said it was horrible painful, but it was worth it to have it fixed more quickly.

Well, we had an unintended “controlled study” in our family.

My brother had the frozen shoulder and did all the extremely painful PT stuff.

I left mine alone.

Identical healing time.

I did get the second one checked out to make sure it was not a rotator cuff tear as the Physical Therapist I saw thought it was a tear.

Wow, many thanks everyone I feel slightly better knowing that it will get better and there is hope. Some nights and days even its so painful I want to pull my arm off as thought its a toothache (if you know what I mean). I was ironing a shirt for work and the stream wnet over my hand didnt hurt one bit but I reacted with pulling my hand away very quickly it was the frozen should are and the pain that went down my arm was the most intense I have ever ever had I dropped the iron and fell to the floor. I want it to go away more then my diabetes I think at the moment but have some hope it will get better Thank You for responding… x

I’ve struggled with this problem for years. If I made a quick movement, sometimes I would get such intense pain in my right arm that I would scream. Everyone in the house would come running. By the time they got to me the pain was losing it’s intensity. It was awful. Cortizone didn’t do anything except raise my bloodsugar. I did physical therapy for awhile. Finally opted for surgery. Subacromial decompression. I think they removed the end of my scapula to give everything in there more space. That did eliminate the extreme pain but I never totally recovered. I mean my shoulder is still tight and I do have to keep stretching it. Then, last year, my right shoulder began giving me trouble. I stretch it. The pain isn’t as extreme so will not pursue surgery. Strengthening and stretching are important for everyone’s shoulders. It helps prevent this problem to begin with. It also affects non-diabetic people but is very common in diabetics. I’ve been T1 for 39 years.

Steve,

I’m up for upteenth time at night taking a pain pill. It hurts from my shoulder to my hand. My bloody doctors better better find a cure or a solution on the 5th. I try really hard not to need a pain pill - but what can I do it hurts so bad! Its starting to drive me crazy!!! What’s your next step?

Mike.

Steve,

I forgot to mention but the diagnosis I been given before see the Orthpodic folks is Inpingement Syndrome. After looking it up on the net seems to fit. Sounds like a few more diagnostic tests to confirm. Not sure how this relates to Diabetic Frozen shoulder. You might check it out yourself. Final cure at least from the net will be some sort of surgery - I am ready to enbrace this if its a cure. Mike

Steve - see if this describes you - Mike

Each of these three conditions, shoulder impingement, tendinitis or tendonitis, and bursitis usually happen at the same time. As a result, the terms are often used interchangeably. The reasons why these conditions may not get better by themselves are related to the frequency with which the cuff is irritated and to the changes that occur in our bodies as we grow older. Repetitive activity that irritates the rotator cuff may increase the amount of inflammation, and the aging process makes it more difficult for the inflammation to heal. Doctors believe that the blood supply to the tendon may decrease as we get older, causing the tendon to get weaker and possibly making it more difficult for the body to heal small tears or inflammation.

While most patients usually try to ignore the first signs of pain, they often visit a doctor after the pain has started to prevent them from sleeping well. Shoulder pain that makes it difficult to fall asleep is a common symptom of impingement syndrome and rotator cuff tendinitis. Most patients with this type of shoulder pain do not have a history of a bad shoulder injury, a dislocation, or an episode of the shoulder giving way. At first, most people notice only minor pain and a slight loss of strength. Subtle changes in range of motion, and especially in the ability to lift the arm overhead, may be ignored for a while. However, as symptoms progress, the shoulder pain and limited motion become more difficult to ignore.

Steve,

That kind of pain is EXACTLY what I experienced with my second frozen shoulder. It started in September, by mid October I was living on pain pills and still hurting, but by December it had calmed down considerably and eventually it faded out completely. As far as “most painful thing I ever experienced” goes, it came in second to my 23 hours in obstructed labor, but that isn’t something you’ll have to worry about.

If it is a frozen shoulder rather than a tear nothing structural is permanently broken, instead as I understand it what happens is you get swelling, swelling pinches nerves, that causes muscle spasm to freeze the muscle around the injury to protect it.

Studies that I looked at found that cortisone shots did not improve the healing time. Since cortisone shots really screw up blood sugar control don’t let a doctor push you into having them. I think they give you the shot so they can make you feel like you got something in return for the very expensive appointment.

If you’re doing web research, the technical name is “Adhesive capsulitis.”

Hi
I have had D for 43 years and had frozen shoulders X2. I had cotisone injections in both , which calmed things down in one ( I know it raises blood sugar temp.). The other shoulder gives me problems off and on. Although not exclusive to D’s we do have a proclevity towards these things

Steve:

I had a nasty bout with a frozen shoulder and did it ever hurt. My hand and arm and fingers started involuntary movement and the shoulder was so bad.

After awhile they took x-rays etc and determined there was no visible damage. So I got to a physical therapist and it took about six months but she freed it. Now I have ot be careful to use it, but so long as I do it is free.

rick phillips

Frozen shoulder is one of the connective tissue and muscle disorders that diabetics can develop. Others are carpal tunnel, trigger fingers, ulnar nerve compression, and others–largely due to inflammation. I did not find this out until I began to have problems such as bi-lateral carpal tunnel, frozen shoulder and, finally trigger fingers. I went to PT for about 3 months and I also had acupuncture which worked great. It has been a year and I still have some of the symptoms, but I can move the arm much better. I did not take narcotics only Motrin 800mg and neurontin which I take for neuropathies. I have been T1 diabetic for 40 years. Unlike neuropathy, some of these conditions are not necessarily tied to BS control. According to my brother in-law who is a doctor, they don’t really know where the inflammation comes from, but they know that a lot of T1s have inflammation.

I would avoid pain narcotics since they are addictive, but you can try the same cocktail that I take and/or nortripylin which is an antideppressant but it is also used to suppress pain.

My best to you.

Marie

I had surgery on my left frozen shoulder last autumn. My shoulder had been playing up for about a year before I actually went to my doctor after having seen an osteopath friend of mine who suspected frozen shoulder and told me to see my GP. Frozen shoulder was eventually diagnosed and I had weekly physiotherapy for a couple of months without any improvement. I was then referred to the hospital where it was decided that capsular release surgery would be the best option. By this time I couldn’t raise my left arm to the usual 90-degree position you would adopt to alert a bus driver to stop and pick you up.

I was in hospital for five days and the surgery itself went well with physiotherapy starting within a few hours of coming round from the operation. My diabetes control was messed up big time on the sliding scale, but that’s another story. I then had weekly physiotherapy until early January, but I had to do physio exercises three times a day at home.

It was keyhole surgery, although there are three noticeable scars on my left shoulder. The surgeon explained that during the operation he shaved off “spurs”, or bits of bone that impede movement. My left shoulder is now so much better and there’s no pain at all and I can sleep on it without the worry of experiencing discomfort. Movement has returned, although I cannot say that it’s absolutely perfect or that I’ll ever be able to do a routine on the parallel bars;-)). There’s mild stiffness at the limit of my range, but I am able to do everything that’s necessary to lead a “normal” life.

Now for the bad news: my right shoulder has started to go the same way in the last few months!

Hello
I am a Type 2 since 2005, and I developed frozen shoulder about 14 months ago. The doctor said to just ride it out, and it would cure itself in 18 months to 2 years, but it would never have the strength and range of motion (ROM) that it had previously.
Last July (12 months ago), I discovered the best exercise program no one has heard of–kettlebells. Google it for an explanation of what kettlebells are. I found a forum about kettlebells (dragondoor.com), and learned in the forum about many people fixing shoulder problems, even fixing frozen shoulder. Interesting, I thought. They had my attention.
Two things in every post kept popping up–kettlebell “arm bars” and Kettlebell “turkish get ups” (go to You Tube and search for kettlebell arm bars and kettlebell turkish get ups). I began to do arm bars with my kettlebells 3 or 4 times a week. My range of motion in my bad shoulder gradually increased, but it was still very painful, and I still couldn’t raise my arm completely over my head, or behind my back, nor could I sleep on that side in bed without a lot of pain. I was better, and ROM had increased, but still was a long way from being “cured”.
This February, I started trying to do Turkish get ups. I had to start without even using a kettlebell, three or four times a week, because I simply had no strength in my bad shoulder, and my ROM was still so poor, that I couldn’t perform the movement correctly. I kept stretching (an excellent book with exercises to stretch and strengthen shoulders is “Secrets of the Shoulder” by Gray Cook), kept doing arm bars, and kept doing TGU’s with no weight, and gradually, my ROM and strength began to return. In March, I was able to do my first TGU with an 8 pound kettlebell, and best of all, no pain while doing the exercise. In the past three months, I have gone from an 8 pound TGU to a 53 pound TGU, and my shoulders have never felt better. My ROM is the same now in both shoulders, and best of all, no pain now for 3 months. I can sleep in any position, and put my arms where I want them–cool stuff considering where I was at 4 months ago.
I do not know if kettlebells, stretching, and these two simple exercises can help you, but it might be worth a shot.
My doctor was dumbfounded when I showed up at the last appointment. He checked my ROM and strength, and the first thing he asked me was “what in the hell have you been doing?” I explained about kettlebells and the stretching, and the two exercises, and he replied "it makes sense. Frozen shoulder is brought on by inactivity, and you broke the mold by activating and stretching those unused muscles. But most of all you strengthened the stabilizer muscles in your shoulder, thereby taking a load off the weak major muscles. You balanced yourself out, and now your major muscles are as strong, or stronger than before, as well as your should stabilizers."
I thank kettlebells every day for correcting my frozen shoulder, in a very short amount of time.

I had this strike about 1997 IIRC, after 41 years as a Type 1. Looked it up on the Intenet and found information saying it was “adhesive capsulitis”, where the small lubricating capsules that are in between the joint ball and socket in the shoulder get stiffened up by higher than normal, though not necessarily long term, excessive bg levels that we tend to have.
The recommended treatment was to excercise several times daily by standing near a wall on the affected side, raise it so the hand reached the wall as high as was comfortable and lean on the wall, then stretch it more, to the point where it hurt somewhat.
Not fast or easy, it took roughly 2 years to clear it up totally, but I haven’t had it since.

Thanks Dena for sharing as that is the same exactly thing that I am currently going through right now. My right shoulder was that way then after 2-3- years the pain went away but my range of motion is so limited. Now my left shoulder is acting up. Any quick movements or trying to pull myself up with the left arm the pain is unbearable. At this point in time I am not so sure how much longer I can continue with my job as it is physically demanding. I wish that I could spray some WD-40 into my shoulder joint and see if that would help : )
I have had Type 1 for 35 years.

Yes I have experienced this condition in both of my shoulders. I chose to use a physical therapist who was great. I went once a week to her office and she would give me exercises to work on at home. It’s painful, but successful treatment depends on a persons willingness to perform the exercises regularly. It takes a long time and typically has 3 different stages. One of my shoulders took almost 2 years and the other did take 2 years. I have full range of motion in 1 of them, and almost full range of motion in the other. I compete in triathalons and have been able to swim. If you are able to get in a pool it will help very much.The shoulder that took over 2 years required a doctor to perform sedative minipulation. It’s very important not to let the shoulder become imobile. I started to loose strength in my shoulder and found that rubber exercise bands worked well and helped maintain some of the strength in my shoulder. It is a pain that doesn’t go away for a long time. I had difficult sleeping and had to sleep oonly on my back. I also visited with a deep muscle message therapist which helped a great deal. I feel your pain. Try not to let that scar tissue bulid up. Arm circles starting small to large do them all day long. Trying to get your wallet out of your pocket becomes difficult, but is a good exercise. Personally I would’t take the pain killers, I just used anti-inflammatories. Hope this helps…Mike