This factsheet is for people who have Frozen Shoulder, also known as Adhesive Capsulitis, or who would like information about it. Frozen shoulder (adhesive capsulitis) is a condition that causes pain and stiffness in your shoulder, eventually making your shoulder difficult to move.
- About frozen shoulder
- Symptoms of frozen shoulder
- Causes of frozen shoulder
- Diagnosis of frozen shoulder
- Treatment of frozen shoulder
- Prevention of frozen shoulder
About frozen shoulder
Your shoulder joint (also known as the glenohumeral joint) is a ball and socket joint. Normally, the ball at the end of your upper arm bone (humerus) moves smoothly in the shallow socket on the edge of your shoulder blade (scapula). Strong connective tissue, called the capsule, surrounds the joint. Frozen shoulder is a condition that occurs as a result of inflammation (soreness and swelling) around your shoulder joint and its surrounding capsule. You’re more likely to get frozen shoulder if you’re aged between 40 and 60. It’s also more common among women than men. There are three stages of frozen shoulder.
- Freezing. During this stage you will slowly develop pain that gets worse as you lose motion in your shoulder. This stage can last between six weeks and nine months.
- Frozen. The pain may have settled during this stage but your shoulder will remain stiff. This can last between four and six months.
- Thawing. During this final recovery stage you will begin to get movement back in your shoulder. This stage can last between six months and two years.
Symptoms of frozen shoulder
Symptoms of frozen shoulder include:
- a dull or aching pain in your affected shoulder
- stiffness around your shoulder joint
- restricted range of movement in your affected shoulder
The stiffness may make it difficult for you to do everyday tasks, such as driving, dressing or sleeping. You may also have difficulty scratching your back or putting your hand in your back pocket. The pain usually comes on gradually, and is often worse when you move your shoulder joint. It may also be worse at night. These symptoms may be caused by problems other than frozen shoulder. If you have any of these symptoms, see your GP for advice.
Causes of frozen shoulder
The exact reason why frozen shoulder develops is not known at present. It’s thought to be caused by inflammation of your shoulder joint and its surrounding capsule. Frozen shoulder can sometimes develop if you have had a shoulder injury, such as a fracture, or if you have had surgery on your shoulder. Some medical conditions can increase your risk of getting frozen shoulder, including:
- hypothyroidism and hyperthyroidism
- Parkinson’s disease
- cardiovascular disease
Frozen shoulder is estimated to affect two in 10 people with diabetes at some point in their life.
Diagnosis of frozen shoulder
If you think you have frozen shoulder, see your GP or Chiropractor. Each will ask about your symptoms and examine you. He or she may also ask you about your medical history. You may be referred for one or more of the following tests.
- XRay. This uses radiation to produce an image of the inside of your shoulder.
- MRI scan. This uses magnets and radiowaves to produce images of the inside of your shoulder.
- Ultrasound. This uses sound waves to produce an image of the inside of your shoulder.
WE PERFORM THESE IMMEDIATELY SO THAT A SWIFT DIAGNOSIS AND TREATMENT CAN BEGIN
These tests can rule out other causes of your shoulder stiffness and pain, such as rotator cuff orosteoarthritis.
Treatment of frozen shoulder
Frozen shoulder will usually get better on its own. However, it can sometimes take years to completely go away. Treatment for frozen shoulder depends on the stage of your condition.
As soon as a diagnosis is made and a full understanding explained to the patient about the type and severity of the shoulder problem treatment begins. The inflamed tissues are calmed with ultrasound and laser with gentle home icing initially. As soon as the pain is reduced careful mobilization and then manipulation is used. Specific trigger point pressure is applied to the restrictive muscle fibrosis and swift progress is made. We then treat aroud the area, making sure that the mid thoracic spine and lower cervical spine are able to function correctly and not restrict the improving shoulder. I find that there are clear differences in presentation of shoulder pain; The agony shoulder with complete restriction and inflammation and the fibrotic and stiff chronic one. Both of the need the correct diagnosis and treatment protocol otherwise a great deal of time and treatment is wasted. Fundamentally its about early diagnosis and intervention. Once injections have been done it is much more complicated.
If you need pain relief during the first stage of frozen shoulder, you can take over the counter medication, such as paracetamol, or non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice. During the early, freezing stage, your GP may advise you not to move your shoulder in any way that causes you pain, for example, overhead lifting or vigorous stretching. It’s important, however, to continue moving your shoulder regularly during day-to-day activities and not to stop moving your shoulder completely. Around nine out of 10 people find that the pain gets better and the movement improves after following these self-help treatments.
Your GP may refer you to a physiotherapist (a health professional who specialises in maintaining and improving movement and mobility), who will show you suitable exercises to help stretch your shoulder muscles and improve the strength and movement of your shoulder. See link for more information about exercises. If your frozen shoulder is severe or if it isn’t getting better after trying other types of treatment, your GP may give you asteroid injection.
You may need to have surgery if other types of treatment haven’t been helpful. The following are the most common surgical methods.
- Shoulder manipulation. Your surgeon will move your shoulder around, while you are under general anaesthetic. This means that you will be asleep during the procedure.
- Shoulder arthroscopy. A type of keyhole surgery, which can be used to look inside and treat your shoulder joint. This is usually done under local anaesthetic.This completely blocks pain from your shoulder area and you will stay awake during the procedure. However, sometimes you will be under general anaesthesia because it can be uncomfortable for some people to stay in one position for the length of time needed to complete the procedure.
Sometimes both of these procedures are done at the same time. Most people who have surgery will have good results. If you have surgery, you will need to have physiotherapy to maintain the motion in your shoulder. It can take between six weeks and three months for you to recover.
Prevention of frozen shoulder
The best way to prevent frozen shoulder is to get treatment as early as possible if you injure your shoulder or develop shoulder pain that limits your range of movement. It is one of those problems that needs treatment ASAP.
To book a consultation with us, please call our friendly reception team on (Torbay) 01803 329799 or (Teignmouth) 01626 7744222