Frozen Shoulder

Frozen shoulderT, The common name for adhesive capsulitis.

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What is Frozen Shoulder?

In frozen shoulder, the capsule of thin tissue that encloses your shoulder joint becomes inflamed, causing pain, and over time it becomes thickened causing a loss of movement in the shoulder. In most cases it will almost fully resolve but this can take time (up to 1-3 years on average, occasionally longer). It’s not clear what causes frozen shoulder. It most often affects people between the ages of 40 and 60 and is more common among people with diabetes and some other medical conditions. It can also happen after a shoulder injury or sometimes after shoulder surgery.

Frozen shoulder usually begins with pain around the shoulder or upper arm which may be worse at night. Over several weeks, you may notice a loss of movement in the shoulder. It may become difficult to move your arm above your head or behind your back.

CONTINUE TO SYMPTOMS

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Symptoms

Stage One

Painful Stage

The first symptom of frozen shoulder is usually pain. Pain can be severe initially, and this may last for several months. An injection of corticosteroid into the shoulder joint has been shown to be helpful in managing pain during this phase. During this phase, continue daily activities as comfort allows, but avoid aggressive stretching, exercise or activities that significantly aggravate your pain. Your physiotherapist may be able to provide some education and advice about READ MORE
Stage Two

Freezing Stage

During this phase the pain will gradually improve, but your shoulder will still be stiff and have limited movement (‘freezing’). This phase can last up to 12 months. Once the pain has settled physiotherapy may be of benefit to help gradually stretch and mobilise the shoulder to help restore movement.
Stage Three

Thawing Stage

In this stage, pain is almost completely gone and the shoulder starts to ‘thaw out’, with movement gradually returning over a period of 1-3 years. Sometimes it can take up to three years to recover fully. In some patients it may take longer. At this stage it’s important to see a physiotherapist for exercises that will help you get full movement back and to strengthen your upper back and shoulder muscles. The time frames in each stage vary for individual patients and, READ MORE

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Treatments

One

No Treatment

Because most frozen shoulders eventually resolve, some patients opt not to pursue any treatment.
Two

Freezing Stage

The is good research evidence that an injection of corticosteroid (anti-inflammatory) into the glenohumeral (shoulder) can be beneficial treatment for managing pain in the early (pain predominant) stages of frozen shoulder. This may help with pain, but it won’t improve the shoulder stiffness. The injection can be performed by a medical practitioner, or under imaging-guidance by a radiologist. The effect may last several weeks to several months. Some people with diabetes READ MORE
Three

Physiotherapy

Once the pain has settled, and pain is not disturbing your sleep your physiotherapist can guide you in gradual stretching, mobilisation and strengthening of your shoulder.
Four

Manipulation under anaesthetic

If your shoulder movement is not improving in an appropriate time-frame, a ‘manipulation’ of the shoulder under general anaesthesia may be offered. This involves a period of brief general anaesthesia during which the shoulder is gently moved through its full range of movement along with a corticosteroid injection to help with pain.
Five

Surgical (Arthroscopic) release

The is good research evidence that an injection of corticosteroid (anti-inflammatory) into the glenohumeral (shoulder) can be beneficial treatment for managing pain in the early (pain predominant) stages of frozen shoulder. This may help with pain, but it won’t improve the shoulder stiffness. The injection can be performed by a medical practitioner, or under imaging-guidance by a radiologist. The effect may last several weeks to several months. Some people with diabetes READ MORE
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