Menopausal Frozen Shoulder

I was very interested to read this-in the past two years after experiencing none of the usual symptoms of the menopause, I have had to have two steroid injections for a frozen shoulder and I have had two for "tennis elbow", one of which did do the trick[ despite being excruciatingly painful] , the other having failed miserably.

I have limited movement in my shoulders and I find the tennis elbow, sore and tiring.

I had never thought of any hormonal connection, but it makes perfect sense.

Thank you.

Juno

I'm glad it helped Juno. I admit to being slightly evangelical about spreading the word...I simply cannot believe so many GP's do not immediately put two and two together when a woman of a 'certain age' presents with sudden onset joint /tendon pain/tennis elbow/frozen shoulder. ALL of these conditions, in woman who has never experienced joint problems should be considered as being caused by hormonal changes.

I genuinely thought I had some awful disease, from bone cancer, to motor neurone, to polymyalgia - because I could not believe my body could change so quickly and be so painful and debilitating.

Typically, women who go to the doctor with symptoms of pain and stiffness are tested for inflammatory conditions - and who actually have 'menopausal arthritis' - will test negative, and their bloods will show a very low ESR and CPR. This does not help, as the baffled GP will tend to then assume it is nerve pain...or all in the mind, or Fibromyalgia - and give a low dose amytriptilene, instead of HRT.I believe a lot of women with Fibro actually are suffering from low estrogen.

The first elderly male GP I saw was supposed to be the practice rheumatology expert...and he had never heard of this (and poo poooohed my tentative suggestion that it could be related to meno) yet the nurse practitioner two door down the hall knew all about it? Doesn't make sense to me. I feel I would have been crippled for years if I had not gone to see her.

I am told that I only need to take HRT for a few years, as at some stage the body naturally recognises it has gone through menopause, and adjusts into old age. (What an expression!!) Some women have a natural decline in estrogen and are not affected. It seems to be the the women who have the sudden decline in estrogen/ovarian failure at the end of perimenopause who seem to sufffer the worst, so suddenly and with such ferocity.

I also have a terrible elbow which constantly clicks and pops - so I sympathise with you there too.

Good luck

Lesley

Sorry - I forgot to add - if you google estrogen and joint pain, lots of information comes up. I also discovered that much younger women who have breast cancer are sometimes treated with with drugs to completely suppress estrogen. These women often complain of sudden onset joint and tendon problems and muscular adhesions soon after commencing treatment - which is so debilitating that a lot of them refuse to continue on it.

Hi

I've been following this post with interest. I've had frozen shoulder 3 times in last 20 years. However I'm not a woman...I'm one of the others ! So, please don't all morph into one giant woman and tear me to pieces. I can see that there is likely to be a greater incidence of frozen shoulder in women who have gone through hormonal changes, especially where osteo arthritis might be developing, and this is borne out with the number of postings on the web from women who are over fifty. However, my experiences with FS were seemingly caused by a neck problem I've had for a long time....cervical spondylosis ( age 40 to 55). Each time, although quite painful for a few months, it eventually cleared up after about 10 months and the shoulder returned to normal., without fail. Point I'm making is that there was nothing intrinsically wrong with the shoulder itself, the symptoms were referred muscle spasms from the neck problem. I'm wondering if this could be true for all cases of FS and , if so, I don't see why they should focus on the shoulder for applied treatments. I think its best left alone and not aggravated further in any way. Thus it might heal sooner than one which is continually exercised. I know the Physios etc like to be seen to be doing something positive, but really their interference might be extending the problem. If they were to say that the FS is likely to dissipate after 3 months and disappear after 10 months, on its own, then we could make the choice of whether to interfere or not. In my opinion, a condition which everyone accepts returns to normal with no resulting signs of wear or tear, should not be tested in ways which might leave more permanent damage.

Sorry to nudge in here on a valid argument on why women might be more susceptible to this condition. I just wanted to point out that the cause of FS may be more neck-based than shoulder based, and maybe treatments should be more concentrated appropriately.

HI

Well I'm very confused now. I thought lesley 998 was on to something as I am a 51 year old ( certainly on the change). I'm on my second frozenshoulder /adhesive capsulitis on my none dominant shoulder. I can see why the change in hormones could cause these problems, sounds very logical and something I will look into further. Then Gerry the neck throws a spanner in the works as I can relate to the neck problems having suffered on and off since 1999 with neck pain after disc removed and fused at C6, so could this be were my problems stem from?, yet another avenue to pursue. I had surery last year for frozen shoulder then within 8 weeks needed MUA as it became encapusalted. Now, just over a year on, the same shoulder is frozen again. According to the consultant this is unheard of. I know Gerry you would disagree with that.! I've also read that having too agressive physio is detrimental, infact my consultant has advised against it. I am worried about surgery I am going to have on my other shoulder at the same time as my MUA this is needed due to arthris , floating bone fragment and spur. I think I am going to end up with frozen shoulder again or encapsulitus. But I am hoping that there will be light at the end of the tunnel and after the surgery this time I will be pain free - eventually.

All your comments are very interesitng and food for thought

Hi Gerry - I absolutely agree with everything you've noted - and as I am no doctor or specialist - I have no more of a clue than anyone else! I posted because I was suddenly struck down by this awful painful condition, as are so many menopausal women - and yet no GP seems to recognise it as a symptom of menopause. It is not generally recognised, that sudden onset FS , or any tendon/arthritic issue in women of a certain age - with no previous neck or shoulder or musculoskeletal issues - could be caused by a sudden a reduction in estrogen which rapidly affects these tissues.

Of course this condition affects both sexes equally...as you know to your painful cost. Neck, spine, shoulder problems hormonal issues....who really knows why this condition appears in both men and young women, and menopausal women. But it seems the resulting constricture and debilitating long term shoulder pain is the same, whatever the etiology.

i was speaking to a lady last week about this who I met on another forum. She is 51, has breast cancer and has been on estrogen supressing drugs for six months.She has developed sudden onset severe pain and stiffness in both shoulders and also has problems with both elbow tendons. She is on the waiting list for a scan, and is terrified the cancer has spread to her bones because no one has offered any other idea why she is in so much pain. We both think the estrogen link is just too much of a coincidence and she feels much less concerned now she knows there could be a reason for this sudden condition after never having had so much as a neck twinge in her life.

Although replacing hormones does help as I first posted above - I have to admit I am still in quite a lot of pain with this one bad shoulder. Thankfully I no longer have pains in other joints, or hips and elbows as I did, and perhaps was lucky that hormone replacement halted any further issues.I am sadly coming to the conclusion that of course, nothing can actually 'cure' FS if hormonal loss is indeed the cause.It seems once the damage is done, and the scar tissue has adhered we are playing the same long waiting game as everyone else.

perhaps tabs....you have being dealt a double blow by being both hormonal, and already having had neck issues...I wish you the best in your journey.

Hi Lesley

I agree with you as well. Where women of a certain age start to experience frozen shoulder, there must be a connection to hormonal changes and oncoming osteoarthritis and the estrogen treatments look like the best preventative options in those circumstances. If your advice was heeded perhaps there would be less incidences of FS in that demographic. So, I support your advice. However, where FS has already occurred I think it would be wise to not exclude the neck as a possible cause....the reason being that any subsequent treatments applied to the shoulder might be counter productive. The logic works like this for me....If someone who doesn't have osteoarthritis or isn't experiencing hormonal changes, but still experiences FS, then you have to look for a common cause, something that might apply to both sets of circumstances, but is not only evident in one. So, where I'm advocating a neck based source, and you are advocating a lack of estrogen source, I'd be inclined to put both together and say they don't necessarilly conflict. I've had FS 3 times and I'll vouch that each time it totally disappeared after 10 months or so, with no residual damage. There was no actual fault in the shoulder. So, like you, I get a bit concerned when I read posts that advocate any kind of surgical intervention or strenuous exercises, because I think that could be creating problems for the future. I understand the frustrations that drive people to these treatments, but I think its only right to add a word of caution. Chances are it will self resolve sooner if left alone.

However, I totally agree that what you suggest might help with correcting the prime cause of why FS is so common in post menopausal cases. Sorry if I sound a bit like a medic...I'm not. I'm just very familiar with my own FS incidences. And I always knew it would be difficult to say my bit here, without crossing some lines. I think our intentions are the same but just aimed at different aspects.

Gerry

Hello again all! Been doing more research into this and have found some interesting sites regarding FS in Japan, where hot flushes are so unknown that there is not even a japanese word for it, but the number one symptom of menopause is frozen shoulder...known over there as 'Fifties Shoulder.'

I also found a site from a Vancouver based physio who states that the number one reason for developing frozen shoulder anywhere in the world is being...you guessed it, fifty and female!

I am not allowed to post the link, but if you are interested google Mike Dixon and Electra Health.

...and Garry, again...I know you men get this condition! But this specific thread was to highlight the connection between frozen shoulder and menopausal women.

Hello Lesley998 and others suffering from or who have suffered AC.

I am 55 years old and am just coming up to my one whole year without periods.

I was diagnosed with AC in my right shoulder about this time last year and sent to physiotherapy alongside taking Ibuprofen 400mg.

Whilst the Ibuprofen helped with the pain I was given the usual set of exercises to do (finger walk up wall and various other stretching exercises).

I can now say that the original AC has now resolved, no pain and I can at last lift my arm enough to shave my armpits, reach for things without going 'Owww' and no more of that horrible pain that feels similar to whacking your funny bone and everything has to stop until you can get your breath back again. ROM is not as good as before but perfectly acceptable.

Now I'm getting the same symptoms on the other shoulder. I'm so glad that one resolved before the other as I've heard of people getting "stereo frozen shoulder" which must be horrible.

I must say that I wasn't terribly diligent with the exercises after a couple of months or I would occasionally do the stretches if it was particularly bad but I can say that the condition does seem to resolve itself which I think is important to mention.

My GP was sympathetic and told me that it would resolve in time and he offered me intra-articular injections which he is experienced in giving but I declined as the results can be negligible.

For those with very bad AC and where lifestyle and work is seriously compromised there is MUA (manipulation under anaesthetic) but should only be done by experienced orthopaedic surgeons and sounds awful! The YouTube video of the procedure put me off, even though it was done under GA.

Another interesting treatment is pumping in sterile water and anti-inflammatory infusion into the joint to "re-oil" the joint and gently break the adhesions. This is done with the patient awake under local anaesthetic but is only practised by a few hospitals/consultants in the UK.

Totally agree that it's menopause related, I have 3 friends who are going through or been through "the change" and they have all had frozen shoulder at that time too.

I am not going to have HR as my doctors practice do not approve of it except in exceptional circumstances and the only other symptoms I have are hot flushes at night but there again I'm patiently waiting for this to subside and cuddle my "Chillow" instead!:D

Hi Fusspot....

I had my HRT increased to the highest dose as along with the FS in my left shoulder, I was starting to get worse symptoms in my right shoulder, my elbows, and was starting to get problems with my hips too. I was just about at my wits end. I have to say, I feel the benefit of HRT - having estrogen back again has made a huge difference to my joints and tendons and I truly believe it has turned me back into a 50 year old instead of a 90 year old cripple.

Hi everyone,

I am brand new to this forum and come out of total frustration. 5 years ago I had a terribly painful case of frozen shoulder. I had an MRI and an ultrasound which revealed a possibility I tore ever so slightly my rotator cuf. The examination was inconclusive but I got teh FS after moving a very heavy treadmill out one room down a hall and into another. i really over stressed the joint and thought I just had sore muscles. It took me 4 years to recover which included the shot in the shoulder twice and PT. I eventually gave up the PT as every time I went it set me back very painfully for at least 3 weeks. I was warned by the specialist that in most cases once having a FS you will get it some years later in the opposite shoulder. I dismissed this as ludicrous since mine was from a dumb injury. Well here I am 5 years later with a FS in my other shoulder! pooh! This one is different. Very painful yet not as excruciating as the first. I went to the Dr much earlier (last time I waited 3 months of trying to deal with the pain on my own) I did get the shot in teh shoulder but I can't tell it actually helped. I also got a two week batch of anti-inflamatory pills. They did help a bit but now that they are over I notice an increase in the burning and more pain. This one seems more inflamed. I can feel the burning all down the front of my shoulder and into my elbow. Sometimes even under the lower part of my shoulder blade. I am so frustrated because I can't ride my bike, open doors reach for things in the fridge, etc.

I have read the discussion here and am very interested in the idea of a hormonal thing. I am 50 and have had some mild menopausal symptoms since my early 40's. But how to bring this up to my Dr? I am living in the Netherlands and Dr's here tend to get rather disgruntled when patients try to tell them what to look into or how to treat you. Hormone Replacement Therapy? How would I know that this is something I should look into/need? Anyone know if I look forward to getting FS's every 5 years for the rest of my life? Or does it just go away after the two shoulders?

I am so sick of being in pain all the time especially when the first one only just got better (although I do not have the complete full range I used to have. I cannot wash my hair with two hands, style it, shave my pit blah blah. It's horrible. Any advise?