Frozen Shoulder
What is it?
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Also known as adhesive capsulitis.
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There is no clear cause for frozen shoulder. The tissue around the shoulder becomes inflamed and then tightens and shrinks causing pain and lack of movement.
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It is most commonly in those aged 40-60, affecting women more than men.
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It occurs more commonly in those with diabetes.
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It can happen after an injury or surgery, or without any precipitating factors.
There are 3 stages of frozen shoulder:
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Freezing Stage - painful stage with loss of shoulder movement. Pain is often worse at night. Generally lasts 3-9 months.
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Frozen Stage - pain levels often begin to settle but movement loss can progress further. May be still unable to perform movements such as reaching your hand behind your back, reaching forwards or sideways. Generally lasts 4-12 months.
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Thawing Stage - movement begins to return and symptoms improve. Generally lasts 12-42 months.
Typical Symptoms/features:
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Gradual onset of shoulder pain which may radiate down the arm to the elbow with reduction in movement.
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Pain often worse at night.
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Loss of shoulder rotation (taking your hand away from the body or putting your hand behind your back), shoulder flexion (reaching up) and shoulder abduction (reaching sideways).
Management:
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Activity modification
- When you first start noticing pain, it may help to reduce your activity for a time to allow the pain to settle.
- However, keeping your shoulder moving and active can help maintain the strength in the shoulder.
- You may need to alter the way your get dressed or do your hair (e.g. put your affected arm in first to a shirt or jacket sleeve).
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Ice or heat.
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Pain relief.
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Physiotherapy – during the freezing and frozen stages, maintenance exercises can be given. Once the thawing stage is reached, more range of movement and strengthening exercises can be introduced.
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Orthopaedic Options: more invasive options are available such as corticosteroid injection, Hydrodilitation and possible manipulation under anaesthetic.
Do I need imaging?
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X-rays can be used to rule out bony pathology (e.g. dislocation or osteoarthritis). People with frozen shoulder will generally have normal X-rays.
