Frozen Shoulder and Diabetes….. Is There A Connection?

Frozen Shoulder, AKA “adhesive capsulitis” is a common shoulder condition that I treat in my SE Portland chiropractic and nutrition clinic, Optimum Function (http://optfunction.com). What suprises patients is when I ask about their blood sugar or hemoglobin A1c; often, no one has considered diabetes, pre-diabetes or another physiologic cause of their shoulder issue.

Frozen Shoulder is a syndrome (meaning, a set of symptoms) that is not well-defined but usually consists of painful restriction of shoulder movements that results in overall decreased shoulder mobility. It is often deemed “idiopathic”; this means that there is usually no identifiable cause for the problem.

To consider all frozen shoulders idiopathic would be overlooking a variety of physiological states that can lead to this condition.

Possible Non-Mechanical Causes of Frozen Shoulder

The physiological conditions most commonly associated with frozen shoulder are diabetes, hypothyroidism/hyperthyroidism, and hypertriglyceridemia.

Here are some facts when considering the link between diabetes and frozen shoulder:

• The incidence of frozen shoulder is 2-4 times higher in people with diabetes than in the general population.
• The total prevalence of diabetes (frank diabetes and pre-diabetes or metabolic syndrome) in patients with frozen shoulder was 71.5%
• Shoulder capsulitis is common in type I and type II diabetic patients. However, it is occurs more commonly as the diabetic patient ages

Why???

Patients with diabetes clearly have a higher incidence of frozen shoulder. While the “why” behind these stats is not clear, we can speculate that poor circulation may lead to abnormal collagen repair and speed up degenerative changes. The theory is that platelet derived growth factor is released from blood vessels that have become inefficient due to the diabetic condition. This growth factor will then act as a stimulus to scar tissue development which will help to continue this process leading to a vicious cycle that started because diabetics have problems with the small, peripheral blood vessels.

So, please take this information the next time someone tells you that your shoulder dysfunction can be diagnosed as Frozen Shoulder. Click on the following link to download and shar this article with friends and loved ones: Diabetes and Frozen Shoulder Article

1. Parada-Turska J, Majdan M, The musculoskeletal system in diabetic patients,Postepy Hig Med Dosw, 59:236-44, 2005
2. Sattar MA, Luqman WA, Periarthritis: another duration-related complication of diabetes mellitus, Diabetes Care, Sep-Oct;8(5):507-10, 1985
3. Milgrom C, Novack V, Weil Y, Jaber S, Radeva-Petrova DR, Finestone A, Risk factors for idiopathic frozen shoulder, Isr Med Assoc J, May;10(5):361-4, 2008
4. Cole A, Gill TK, Shanahan EM, Phillips P, Taylor AW, Hill CL, Is diabetes associated with shoulder pain or stiffness? Results from a population based study, J Rheumatol, Feb;36(2):371-7, 2009
5. Tighe CB, Oakley WS Jr, The prevalence of a diabetic condition and adhesive capsulitis of the shoulder, South Med J, Jun;101(6):591-5, 2008
6. Mavrikakis ME, Sfikakis PP, Kontoyannis SA, Antoniades LG, Kontoyannis DA, Moulopoulou DS, Clinical and laboratory parameters in adult diabetics with and without calcific shoulder periarthritis, Calcif Tissue Int, Oct;49(4):288-91, 1991
7. Balci N, Balci MK, Tüzüner S, Shoulder adhesive capsulitis and shoulder range of motion in type II diabetes mellitus: association with diabetic complications, J Diabetes Complications, May-Jun;13(3):135-40, 1999
8. Morén-Hybbinette I, Moritz U, Scherstén B, The painful diabetic shoulder, Acta Med Scand.219(5):507-14, 1986
9. Arkkila PE, Kantola IM, Viikari JS, Rönnemaa T, Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases,Ann Rheum Dis, Dec;55(12):907-14, 1996

Share on Facebook