Hormone therapy linked to shoulder pain and loss of motion prevention in menopause

Adhesive capsulitis is a painful orthopedic disorder described as sudden pain and loss of range of motion, mostly affecting women 40 to 60 years old often without a significant shoulder injury. Associated medical conditions include diabetes, breast cancer treatment, and thyroid dysfunction.

While steroid injections can help decrease the severity of the condition if caught early, there is no known sex-specific or preventive treatment for adhesive capsulitis.

There has been little research investigating adhesive capsulitis’ association with perimenopausal women; however, a study recently presented at the North American Menopause Society Annual Meeting (NAMS) found that hormone therapy may help protect against it.

"Many menopause symptoms fall outside the FDA-approved indications for systemic hormone therapy, including those involving the musculoskeletal system. Our collaborative study between the Departments of Orthopedic Surgery and ob-gyn highlights this point and will hopefully lead to more research in this area," said Anne Ford, MD, associate professor of obstetrics and gynecology and coauthor of the study from Duke University Medical Center.

Researchers of the study hypothesized that estrogen may play a role in this condition because menopause is described as a loss of estrogen and occurs during the same age period as adhesive capsulitis (40-60 years).

In the study, investigators aimed to determine if hormone therapy played a protective role again adhesive capsulitis, enrolling approximately 2000 women. According to the researchers, this is the first known study to investigate hormone therapy as a preventative treatment for adhesive capsulitis in menopausal women.

"As a female orthopedic surgeon in a field that is 94% male, I feel it is important to study sex-specific factors and treatment strategies that may benefit women with adhesive capsulitis. A disease that has such a strong predilection for women is unlikely to be truly idiopathic," said Jocelyn Wittstein, MD, coauthor of the study and faculty member of the Department of Orthopedic Surgery at Duke University Medical Center.

The study results demonstrated that women who did not receive hormone therapy had greater odds of adhesive capsulitis. However, investigators said there is still a need for more studies to back up these findings.

"Hormone therapy has already been proven to effectively manage many other symptoms that accompany the menopause transition,” said Stephanie Faubion, MD, MBA, NAMS medical director.

She concluded, “This study suggests that there may be an additional benefit in its ability to protect women at menopause against adhesive capsulitis. More research is needed in this area because the disorder can significantly affect a woman's range of motion and overall quality of life."

Reference:

Ford A, Wittstein J. Hormone Therapy May Help Prevent Shoulder Pain and Loss of Motion in Menopausal Women. Presented at: North American Menopause Society Annual Meeting. October 12-15, Atlanta, Georgia.