An Updated Overview of Risk Factors for Shoulder Stiffness

Abstract

A painful reduction in shoulder mobility, known as “shoulder stiffness”, can occur both as a primary idiopathic condition and as a secondary condition, for example, following surgical procedures. Various factors can contribute to the development of primary shoulder stiffness. In this review we summarize the pathophysiological mechanisms, genetic influences, endocrine disorders, metabolic conditions, as well as other diseases and medical-therapeutic approaches that might have an impact on the development of primary shoulder stiffness.

Keywords

shoulder stiffness - frozen shoulder - adhesive capsulitis - inflammation - risk factors

Publication History

Received: 30 August 2023

Accepted: 11 January 2024

Article published online:
08 March 2024

• References

• 1 Itoi E, Arce G, Bain GI, Diercks RL. et al. Shoulder Stiffness: Current Concepts and Concerns. Arthrosc J Arthrosc Relat Surg 2016; 32: 1402-1414
• 2 Cucchi D, Menon A, Maggi S. et al. Treatment of partial rotator cuff lesions is associated with a higher frequency of post-operative shoulder stiffness. A prospective investigation on the role of surgery-related risk factors for this complication. Arch Orthop Trauma Surg 2021; 142: 3379-3387
• 3 Hand G, Carr A. Natural history and genetics of frozen shoulder a 1–20 year follow up of 273 patients. Orthop Procs 2005; 87-B(Supp. II): 161
• 4 Le HV, Lee SJ, Nazarian A. et al. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow 2017; 9: 75-84
• 5 Ling Y, Peng C, Liu C. et al. Gene polymorphism of IL-6 and MMP-3 decreases passive range of motion after rotator cuff repair. Int J Clin Exp Pathol 2015; 8: 5709-5714
• 6 Martelossi Cebinelli GC, Paiva Trugilo K, Badaró Garcia S. et al. TGF-β1 functional polymorphisms: a review. Eur Cytokine Netw 2016; 27: 81-89
• 7 Cohen C, Leal MF, Loyola LC. et al. Genetic variants involved in extracellular matrix homeostasis play a role in the susceptibility to frozen shoulder: A case-control study. J Orthop Res 2019; 37: 948-956
• 8 Hildebrand KA, Zhang M, Befus AD. et al. A myofibroblast-mast cell-neuropeptide axis of fibrosis in post-traumatic joint contractures: an in vitro analysis of mechanistic components. J Orthop Res 2014; 32: 1290-1296
• 9 Hakim AJ, Cherkas LF, Spector TD. et al. Genetic associations between frozen shoulder and tennis elbow: a female twin study. Rheumatology (Oxford) 2003; 42: 739-742
• 10 Wang K, Ho V, Hunter-Smith DJ. et al. Risk factors in idiopathic adhesive capsulitis: a case control study. J Shoulder Elbow Surg 2013; 22: e24-e29
• 11 Harzy T, Benbouazza K, Amine B. et al. Idiopathic hypoparathyroidism and adhesive capsulitis of the shoulder in two first-degree relatives. Joint Bone Spine 2004; 71: 234-236
• 12 Rizk TE, Pinals RS. Histocompatibility type and racial incidence in frozen shoulder. Arch Phys Med Rehabil 1984; 65: 33-34
• 13 Prodromidis AD, Charalambous CP. Is There a Genetic Predisposition to Frozen Shoulder?: A Systematic Review and Meta-Analysis. JBJS Rev 2016; 4: e4
• 14 Kulm S, Langhans MT, Shen TS. et al. Genome-Wide Association Study of Adhesive Capsulitis Suggests Significant Genetic Risk Factors. J Bone Jt Surg 2022; 104: 1869-1876
• 15 Green HD, Jones A, Evans JP. et al. A genome-wide association study identifies 5 loci associated with frozen shoulder and implicates diabetes as a causal risk factor. PLOS Genet 2021; 17: e1009577
• 16 Kim SK, Khan C, Ladd AL. et al. A shared genetic architecture between adhesive capsulitis and Dupuytren disease. J Shoulder Elbow Surg 2023; 32: 174-185
• 17 Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J 2016; 6: 26-34
• 18 Chuang SH, Chen YP, Huang SW. et al. Association Between Adhesive Capsulitis and Thyroid Disease: A Meta-Analysis. J Shoulder Elbow Surg 2023; 32: 1314-1322
• 19 Braga M, Bhasin S, Jasuja R. et al. Testosterone inhibits transforming growth factor-β signaling during myogenic differentiation and proliferation of mouse satellite cells: potential role of follistatin in mediating testosterone action. Mol Cell Endocrinol 2012; 350: 39-52
• 20 Brue S, Valentin A, Forssblad M. et al. Idiopathic adhesive capsulitis of the shoulder: a review. Knee Surg Sports Traumatol Arthrosc 2007; 15:: 1048-1054
• 21 Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ 2005; 331: 1453-1456
• 22 Huang SW, Lin JW, Wang WT. et al. Hyperthyroidism is a Risk Factor for Developing Adhesive Capsulitis of the Shoulder: A Nationwide Longitudinal Population-Based Study. Sci Rep 2014; 4: 4183
• 23 Bunker T. (ii) Frozen shoulder. Orthop Trauma 2011; 25: 11-18
• 24 Park HB, Gwark JY, Kam M. et al. Association between fasting glucose levels and adhesive capsulitis in a normoglycemic population: a case-control study. J Shoulder Elbow Surg 2020; 29: 2240-2247
• 25 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie e.V., D-A-CH Vereinigung für Schulter- und Ellenbogenchirurgie e.V.. Schultersteife: 1. Auflage. 2022 Accessed February 22, 2024 at: https://www.awmf.org/leitlinien/detail/anmeldung/1/ll/187-020.html
• 26 Rai S, Kashid M, Chakrabarty B. et al. Is it necessary to screen patient with adhesive capsulitis of shoulder for diabetes mellitus?. J Fam Med Prim Care 2019; 8: 2927-2932
• 27 Cucchi D, Di Giacomo G, Compagnoni R. et al. A high level of scientific evidence is available to guide treatment of primary shoulder stiffness: The SIAGASCOT consensus. Knee Surg Sports Traumatol Arthrosc 2024; 32: 37-46
• 28 Qiao Y, Yao X, Zhao Y. et al. Increased Expression of Adipokines in Patients With Frozen Shoulder. Am J Sports Med 2023; 51: 3261-3267
• 29 Pietrzak M. Adhesive capsulitis: An age related symptom of metabolic syndrome and chronic low-grade inflammation?. Med Hypotheses 2016; 88: 12-17
• 30 Hsu C, Sheu WH. Diabetes and shoulder disorders. J Diabetes Investig 2016; 7: 649-651
• 31 Blonna D, Fissore F, Bellato E. et al. Subclinical hypothyroidism and diabetes as risk factors for postoperative stiff shoulder. Knee Surg Sports Traumatol Arthrosc 2015; 25: 2208-2216
• 32 Qiao YC, Chen YL, Pan YH. et al. Changes of transforming growth factor beta 1 in patients with type 2 diabetes and diabetic nephropathy: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2017; 96: e6583
• 33 Chen YL, Qiao YC, Xu Y. et al. Serum TNF-α concentrations in type 2 diabetes mellitus patients and diabetic nephropathy patients: A systematic review and meta-analysis. Immunol Lett 2017; 186: 52-58
• 34 Dyer BP, Burton C, Rathod-Mistry T. et al. Diabetes as a Prognostic Factor in Frozen Shoulder: A Systematic Review. Arch Rehabil Res Clin Transl 2021; 3: 100141
• 35 Tawfeek W, Addosooki A, Elsayed M. Arthroscopic rotator interval release for frozen shoulder, comparative study between diabetic and non-diabetic patients. SICOT J 2022; 8: 35
• 36 Woods DA, Loganathan K. Recurrence of frozen shoulder after manipulation under anaesthetic (MUA). Bone Joint J 2017; 99-B: 812-817
• 37 Jenkins EF, Thomas WJC, Corcoran JP. et al. The outcome of manipulation under general anesthesia for the management of frozen shoulder in patients with diabetes mellitus. J Shoulder Elbow Surg 2012; 21: 1492-1498
• 38 Bunker TD, Esler CN. Frozen shoulder and lipids. J Bone Joint Surg Br 1995; 77: 684-686
• 39 Wang JY, Liaw CK, Huang CC. et al. Hyperlipidemia Is a Risk Factor of Adhesive Capsulitis: Real-World Evidence Using the Taiwanese National Health Insurance Research Database. Orthop J Sport Med 2021; 9: 232596712098680
• 40 Deng GH, Wei YK. The causal relationship between ever smoked and frozen shoulder: A two-sample Mendelian randomization. Medicine (Baltimore) 2023; 102: e35656
• 41 Huang SW, Wang JY, Lin CL. et al. Patients with Axial Spondylarthritis Are at Risk of Developing Adhesive Capsulitis: Real-World Evidence Database Study in Taiwan. J Clin Med 2020; 9: 787
• 42 Cucchi D, Marmotti A, De Giorgi S. et al. Risk Factors for Shoulder Stiffness: Current Concepts. Joints 2017; 5: 217-223
• 43 Riley D, Lang AE, Blair RD. et al. Frozen shoulder and other shoulder disturbances in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1989; 52: 63-66
• 44 Bruckner FE, Nye CJ. A prospective study of adhesive capsulitis of the shoulder (“frozen shoulder”) in a high risk population. Q J Med 1981; 50: 191-204
• 45 Lu W, Pu B, Wang S. et al. Bidirectional two-sample Mendelian randomization analysis identifies causal associations between cardiovascular diseases and frozen shoulder. J Orthop Surg Res 2024; 19: 116
• 46 Nagy MT, MacFarlane RJ, Khan Y. et al. The Frozen Shoulder: Myths and Realities. Open Orthop J 2013; 7: 352-355
• 47 Brindisino F, Minnucci S, Sergi G. et al. Does the psychological profile of a patient with frozen shoulder predict future outcome? A systematic review. Physiother Res Int 2024; 29: e2056
• 48 Ding H, Tang Y, Xue Y. et al. A report on the prevalence of depression and anxiety in patients with frozen shoulder and their relations to disease status. Psychol Health Med 2014; 19: 730-737
• 49 Pedersen AB, Horváth-Puhó E, Ehrenstein V. et al. Frozen shoulder and risk of cancer: a population-based cohort study. Br J Cancer 2017; 117: 144-147
• 50 Hsu CY, Ke DS, Lin CL. et al. Risk of Herpes Zoster in Patients with Adhesive Capsulitis of the Shoulder. Int J Environ Res Public Health 2020; 17: 3592
• 51 Degreef I, Debeer P. Post-vaccination Frozen Shoulder Syndrome. Report of 3 Cases. Acta Chir Belg 2012; 112: 447-479
• 52 Bass JR, Poland GA. Shoulder injury related to vaccine administration (SIRVA) after COVID-19 vaccination. Vaccine 2022; 40: 4964-4971
• 53 Sahu D, Shetty G. Frozen shoulder after COVID-19 vaccination. JSES Int 2022; 6: 682-685
• 54 Biglia A, Morandi V, Zanframundo G. et al. Adhesive capsulitis after COVID-19 vaccine injection: a peculiar case treated with combined bursa distention and glenohumeral capsular hydrodilatation. J Ultrasound 2023; 26: 909-911
• 55 Cao W, Chen J, Pu J. et al. Risk Factors for the Onset of Frozen Shoulder in Middle-Aged and Elderly Subjects Within 1 Year of Discharge From a Hospitalization That Involved Intravenous Infusion: A Prospective Cohort Study. Front Med 2022; 9: 911532