Shoulder rigidity and arm elevation problems indicate a frozen shoulder. This condition may originate from tendon tears within the shoulder, as demonstrated in this MRI imaging.
Women over 40 seeking medical care at Duke Women's Health in Durham, North Carolina are increasingly reporting a confounding condition: adhesive capsulitis, or "frozen shoulder." According to OB-GYN Anne Ford and orthopedic surgeon Jocelyn Wittstein, three-quarters of individuals affected by this poorly-understood and often agonizing condition are women. Intriguingly, the uptick in cases coincides with the menopausal transition.
Wittstein notes that an alarming 70% of people who go through menopause experience musculoskeletal symptoms, with 25% becoming disabled by them. Women may not recognize joint pain as a potential sign of menopause, Wittstein and her colleagues have suggested in a 2024 scientific review, published in a respected medical journal.
Interestingly, little research has previously been dedicated to understanding the causes of frozen shoulder - until now. In 2023, Ford and Wittstein, who also teach at Duke University School of Medicine, presented research suggesting that menopausal hormone therapy may offer protection against the condition. It is a pioneering first step in a new direction for frozen shoulder research.
The condition, which affects between 2 and 5% of the global population, occurs with age as inflammation strikes the connective tissue surrounding the shoulder joint. During the "frozen" stage, patients can find themselves in a vicious cycle; pain exacerbates inflammation, which in turn makes it difficult to exercise the affected joint. Even with treatments such as steroids, physical therapy, and home exercises, there remains no cure for the condition - sufferers must simply endure until the shoulder "thaws" months or years later.
Those who are prone to developing frozen shoulder include individuals with diabetes, as well as people of Asian descent, where frozen shoulder is the most prominent symptom of menopause. In certain Asian countries, it is even known as "fifties shoulder" or "fifty-year shoulder."
As the body experiences estrogen loss during menopause, joint pain becomes increasingly common. Joint pain during menopause is understudied, but unionized joints may be particularly vulnerable to hormonal shifts. Hormone therapy may offer a promising treatment for such joint pain, according to ongoing research.
In a retrospective study of 1,952 female patients between 45 and 60 years of age, Ford and Wittstein found that those who did not use hormone therapy were 99% more likely to receive a frozen shoulder diagnosis than their counterparts who did use hormone therapy. The study's results, while significant, do not reach statistical significance due to the relatively small sample size. The researchers plan to expand their study to a broader population.
Wittstein and her colleagues have coined a term for the overall effects of hormonal changes on the musculoskeletal system: the musculoskeletal syndrome of menopause. This syndrome increases the risk for joint pain, osteoporosis, and muscle loss in women, which can contribute to aches and pains as women age.
Despite the potential benefits of hormone therapy, there remains a public hesitancy due to misinformation propagated following a 2002 study that showed some adverse outcomes from early forms of hormone replacement therapy. However, hormone replacement has since become safer, and doctors hope that as attitudes change and newer generations of women's health practitioners enter the field, more women will feel comfortable seeking and receiving effective hormonal or non-hormonal treatments for their bothersome symptoms.
Historically, the medical profession has faced significant bias and a lack of research when investigating women's pain. As a result, women have waited longer for treatment than men and have sometimes been diagnosed with psychiatric issues rather than their underlying illnesses. This issue persists even in orthopedics, where women constitute a mere 6% of practicing orthopedic surgeons. Nonetheless, Wittstein remains optimistic that as tenacious researchers continue to investigate, more effective treatments for menopause-related joint issues will emerge.
- The study published in a respected medical journal in 2024 suggested that joint pain, a potential sign of menopause, may be underrecognized by women.
- In 2023, Ford and Wittstein presented research indicating that menopausal hormone therapy may offer protection against adhesive capsulitis, or "frozen shoulder."
- Despite historical bias and lack of research, tenacious researchers, like Wittstein, are optimistic that more effective treatments for menopause-related joint issues will emerge as they continue to investigate.
