What is a frozen shoulder?
Frozen shoulder or otherwise known as an Adhesive capsulitis, is a condition where the shoulder becomes stiff in varying degrees and very painful. Without treatment a frozen shoulder can take 2-3 years.
There are commonly three phases in a frozen shoulder:-
Phase 1 – the ‘freezing’, painful stage. This typically lasts 2-9 months. The stiffness and limitation of range of movement gradually build up. The pain may be worse at night, particularly when you lie on that side.
Phase 2 – the ‘frozen’, stiff stage. This can otherwise be known as the adhesive stage, which can last for 4-12 months. Here the pain starts to ease, whilst the limitation of movement remains or can even get worse. In this phase all shoulder ranges of movement are affected and there may even be some loss of muscle bulk around the shoulder due to lack of use.
Phase 3 – the ‘thawing,’ recovery phase. This can take between 1-3 years. The shoulder becomes less painful and less stiff. Movement can return to normal or almost normal.
However these phases are variable in many cases, and can be less or more severe but in all cases every day activities, getting washed and dressed, sleeping, driving etc. are affected.
Who gets frozen shoulder?
This condition commonly affects people between the ages of 40-65, however women seem to be more frequently affected.. it is also seen more commonly in people who are diabetic, or those people who have an under or over-active thyroid, breast cancer or heart disease. It may even follow after an injury to the shoulder, or even surgery.
It is often seen in the non-dominant side, but can unfortunately affect the other shoulder at some stage in about 1 in 5 people.
What causes a frozen shoulder?
In many cases there is no obvious cause. There are several theories about why it develops. Some feel that scar tissue forms in the capsule of the shoulder. Whilst the capsule is thin and loose around the shoulder, the scar tissue causes it to thicken and shorten and therefore limit the movement. But the reason why the scar tissue develops is still unclear.
How is it diagnosed?
Usually your GP or physical therapist can diagnose a frozen shoulder from examination. It is not necessary to have further investigations such as an X ray or MRI scan of the shoulder unless the diagnosis is unclear.
How can a frozen shoulder be treated?
All treatment aims to reduce the pain and or reduce the stiffness. However the success of each treatment will vary from person to person.
Painkillers such as paracetamol is used in the first instance. If needed then stronger painkillers containing codeine may be an alternative or addition.
Anti-inflammatory medication such as ibuprofen, diclofenac, or naproxyn can be prescribed. These help reduce the swelling in the capsule.
Steroid injection into the shoulder can be given to ease the symptoms and reduce the inflammation.
Surgery may sometimes be considered. This can take the form of manipulation under anaesthetic, where the surgeon moves the shoulder. An alternative can be an arthroscopic capsule release, which is a small operation performed as ‘keyhole’ surgery where the surgeon releases the tight capsule to improve the movement.
Hands on treatment
This can take the form of disciplines such asphysiotherapyorosteopathy to improve the movement. Often these types of therapists will give gentle shoulder exercises to improve the range of movement and prevent further stiffness.
Self help…. It is really important to keep using the shoulder and not stop using it.
Here at the Centre for Complementary Health we have a range of osteopaths, physiotherapists and acupuncturists who would be able to help and guide you further about this condition, so please feel free to give us a call.