After four weeks of physical therapy, the impingement in my right shoulder wasn't getting any better. If anything it was getting worse. It hurts almost always and with certain movements, the pain can ramp up very quickly. And it's double over, take your breath away pain. I can't lift my arm above my shoulder or put my hand behind my back. It's mostly miserable. So I went back to my doctor on Thursday and turns out it's not impingement after all. It's something much worse: adhesive capsulitis or frozen shoulder.

Basically, frozen shoulder has three stages: freezing, frozen, and thawed. I'm in the freezing stage and have been in this stage at various degrees for well over a year. The shoulder issues first started around the same time as the elbow issues, then it would get better, then it would get worse. At one point right before elbow surgery my shoulder was so bad I couldn't reach across and touch my left shoulder with my right hand. My massage therapist worked on it for a couple of visits and it got a lot better. Then I had elbow surgery and it got a lot worse, mostly due to not being able to use my right arm. The limited activity because of my elbow over the last year probably started the whole thing and then age, gender, and a couple of medical issues are also a factor.

The issue will resolve itself eventually but eventually is after 24 months. In the meantime there's the pain and the increasing loss of range of motion. That's the freezing stage. The frozen stage is that the pain mostly goes away but the shoulder is frozen - no range of motion. Then it starts to thaw and pain goes away and range of motion starts to return. However, the problem with that is there's nearly always a loss of some range of motion. The good news is that once you have it in one shoulder, it generally doesn't come back to that shoulder. But it can show up in the other shoulder. The other good news is that the protocol is not to wait for it to thaw and lose range of motion. It can be fixed with arthroscopic surgery. He can go in, clean it out, remove the bursa, manipulate it to "unthaw" it, and then it gets better. Range of motion is supposed to be much, much better too. The bad news is that he can't do the surgery until it gets to the frozen stage because the chances for it to come back if done before then are very high. Doctor thinks I'm about halfway to frozen, which means the pain and loss of motion could get much worse. And that makes me a little depressed because like I said, right now the pain in miserable all the time and incredibly intense at other times. I can't imagine how much worse it could get. To manage the pain I could get another cortisone shot in a different place than the one I had 6 weeks ago but that cortisone shot was not effective at all and I hate doing cortisone shots. There are steroids I could take but they are steroids and apart from the regular side effects with steroids, this can also cause blood flow issues to the shoulder and the hip. Yeah, no. I mentioned to the doctor that I still have Vicodin left from my elbow surgery and I've taken 1/2 of one a few times at night when the pain was really intense and he said to let him know if I needed a refill. That does not bode well.

So for the next 8 months I'm back in physical therapy (and possibly another 6 weeks after that) so I don't lose any more range of motion while I wait for my shoulder to freeze. Then I can have surgery. Fun times. On the plus side it's been four months today since elbow surgery, which is the minimum amount of time the elbow needs to heal. It's doing great, except when a weather front moves through, but it's not considered fully healed until the 1 year mark.