Is rosuvastatin (a statin) causing my frozen shoulder (adhesive capsulitis)?

Rosuvastatin and Frozen Shoulder: Examining the Connection

Rosuvastatin is unlikely to be the cause of your frozen shoulder (adhesive capsulitis), as it has not been specifically linked to this condition in clinical evidence. 1

Statin-Related Muscle Effects

• Statins can cause muscle-related adverse effects, but these typically present as myalgia (muscle pain), myositis (muscle inflammation), or in rare cases, rhabdomyolysis (severe muscle breakdown) 1
• Common statin-related muscle symptoms include non-specific muscle aches or joint pains, occurring in approximately 5% of patients (similar to placebo rates in clinical trials) 1
• Severe myopathy is rare, reported in approximately 0.08% of patients taking statins like lovastatin and simvastatin 1
• Rosuvastatin specifically has not been documented to cause frozen shoulder in clinical guidelines 1

Frozen Shoulder: Causes and Mechanisms

• Frozen shoulder (adhesive capsulitis) is characterized by spontaneous onset of shoulder pain with progressive loss of range of motion 2
• The primary pathology involves inflammation initially and fibrosis later, with inflammatory cytokines, immune cells, and fibrotic growth factors in the synovium and joint capsule 2
• Common risk factors for frozen shoulder include:
  • Diabetes mellitus and hypothyroidism 2
  • Recent breast cancer treatment (particularly in the ipsilateral upper extremity) 1
  • Post-surgical complications affecting the shoulder 1
  • Age (typically 40-60 years) 3

Differential Diagnosis for Shoulder Pain in Statin Users

• Statin-related myalgia: Typically presents as generalized muscle aches without specific joint involvement 1
• Polymyalgia rheumatica-like syndrome: Can develop in patients receiving immune checkpoint inhibitors, presenting with severe myalgia in proximal muscles 1
• Rotator cuff tendinitis: A soft tissue rheumatic disorder that can be mistaken for frozen shoulder 1
• True inflammatory arthritis: May present with joint swelling and elevated inflammatory markers 1

Management Approach for Your Condition

• Physical therapy, including stretching and other exercises, has been shown to be effective for managing frozen shoulder 4, 5
• Intra-articular corticosteroid injections provide significant short-term benefits in pain, range of motion, and function 6, 5
• Oral glucocorticoids may provide early benefit for frozen shoulder symptoms 2
• If you suspect statin-related muscle symptoms:
  • Monitor for more typical statin-related symptoms like generalized muscle pain or weakness 1
  • Discuss with your healthcare provider about measuring creatine kinase (CK) levels if muscle symptoms persist 1

Important Considerations

• Statin-induced muscle symptoms typically affect multiple muscle groups rather than a specific joint 1, 7
• The American Heart Association notes that rosuvastatin is not subject to the same metabolic pathways that interact with many medications that increase myopathy risk 1
• Frozen shoulder is often self-limiting but can have a prolonged course over two to three years 3, 6
• Poor compliance with statin therapy due to perceived side effects can increase cardiovascular risk, so discuss any concerns with your healthcare provider before discontinuing medication 1

If your symptoms persist or worsen, consider discussing alternative causes of your frozen shoulder with your healthcare provider, as the evidence does not strongly support rosuvastatin as the cause of this specific condition.