Frozen Shoulder vs. Rotator Cuff Tear: How to Tell the Difference

Experiencing shoulder pain can be quite limiting. From reaching for a book from the top shelf to driving, mundane daily movements suddenly become challenging. An accurate diagnosis is a critical step toward getting the treatment you need. 

Conditions that cause shoulder pain commonly cause stiffness and limited movement too. Frozen shoulder and rotator cuff tears, two painful shoulder injuries, may appear similar on the surface but are vastly different. 

At DuPage Spine and Orthopaedics in Hinsdale, Illinois, board-certified orthopedic surgeon Kevin M. Koutsky, MD, ensures you receive the most effective care for your shoulder pain. If you’re wondering whether your shoulder pain is from a frozen shoulder or a rotator cuff tear, here’s how to tell the difference: 

Understanding frozen shoulder

Frozen shoulder is a very specific condition in that it arises after a prolonged period of keeping your shoulder still. This might occur after your shoulder was in a cast from another injury, for example. 

When you have a frozen shoulder, the capsule of tissue encasing your shoulder thickens and becomes tight around the joint. Sometimes, it is unclear why this happens. 

Just as the name implies, a frozen shoulder typically comes with a lot of stiffness. Symptoms of a frozen shoulder occur in three stages: 

Freezing stage

In the initial phase, your shoulder is painful with any movement. This stage lasts around 2-9 months. 

Frozen stage

During the frozen stage, which typically lasts for 4-12 months, your frozen shoulder may be less painful than it was during the freezing stage. However, stiffness increases. 

Thawing stage

Your shoulder loosens up during the 5-24 month thawing stage of a frozen shoulder. You can begin using the joint normally again. 

Understanding a rotator cuff tear

Your rotator cuff is a group of four muscles that control your shoulder’s lifting movements and rotation. The rotator cuff attaches your shoulder blade to the head of the humerus, or arm bone. 

When the rotator cuff is torn, movements like reaching and rotating the shoulder become more difficult and painful. However, some rotator cuff tears are not painful but still result in shoulder weakness. 

These tears can happen suddenly or develop slowly over time. Sometimes the tear is minor while other rotator cuff tears completely detach the tendon from the bone. An imaging test can tell you more about the severity of your rotator cuff tear and whether or not you’ll need surgery. 

Diagnosing a frozen shoulder vs. a rotator cuff tear

While diagnosing shoulder pain, Dr. Koutsky goes beyond reviewing your symptoms. He examines your painful shoulder, tests its strength, and tests its range of motion. 

Sometimes a brief physical exam of the shoulder is sufficient for diagnosing a frozen shoulder or a rotator cuff tear. However, Dr. Koutsky may also use X-ray imaging or a magnetic resonance imaging (MRI) scan to view the extent of your shoulder injury. These imaging tests can rule out other possible causes of symptoms such as shoulder arthritis. 

Shoulder injury treatments

Frozen shoulders usually improve without surgery within 12-18 months. Dr. Koutsky and his team can help improve your symptoms with minimally invasive treatments and physical therapy. 

A rotator cuff tear can worsen if you continue using your painful shoulder, so it’s important to consult Dr. Koutsky for treatment. Just like frozen shoulders, many rotator cuff tears can heal with minimally invasive care alone. 

When pain from a frozen shoulder or a rotator cuff tear doesn’t improve with minimally invasive treatment, orthopedic surgery might be the next step in treatment. Dr. Koutsky might also recommend surgery if you’re particularly active or use your shoulder on the job or in sports. 

Are you experiencing shoulder pain?

Persistent shoulder pain or stiffness requires medical attention so you know what it is and how to treat it. Get in touch by calling DuPage Spine and Orthopaedics or requesting an appointment online today.