Frozen Shoulder

What is a frozen shoulder?

Frozen shoulder (adhesive capsulitis) is a common disorder affecting the ball-and-socket (glenohumeral) joint of the shoulder. It is characterised by pain, stiffness, and loss of normal range of motion of the shoulder.

What causes a frozen shoulder?

Frozen shoulder is a progressive inflammatory process that causes the flexible connective tissue of the shoulder joint capsule to thicken and contract losing its normal ability to stretch. The trigger for this process is unclear and can be as trivial as getting a knock to the shoulder or playing a racket sport. In most cases, you may not recall what triggered the episode in the first instance.

Who is at risk of getting a frozen shoulder?

• People aged between 40 and 60, particularly women, are more likely to develop a frozen shoulder.
• Individuals with diabetes mellitus have a much higher risk (between 10-20%) of developing a frozen shoulder. Other medical conditions such as Parkinson's,  thyroid, stroke, or cardiac disease are also associated with developing adhesive capsulitis.
• Individuals who have had to immobilise their shoulder in a sling or a brace, such as after shoulder surgery or an upper limb fracture are at risk of developing post-surgical adhesive capsulitis.

What are the symptoms of a frozen shoulder?

There are two main symptoms of a frozen shoulder: Pain and Stiffness.

• The pain may begin as discomfort that gradually worsens to a constant dull or aching pain. This may be felt spreading down the arm.  A more acute, severe pain may be felt if you move the shoulder to the end of its range in any direction, or if you make a sudden movement.
• There is a gradual reduction of the shoulder range of motion in all directions. Actions like brushing your hair, and putting on a bra or a shirt may become increasingly difficult.

How is a frozen shoulder diagnosed?

The diagnosis of a frozen shoulder is made by taking a medical history, carrying out a clinical examination, and performing a number of imaging investigations, like x-ray and ultrasound scans, to rule out other causes of shoulder pain.

There are a number of conditions that can present like a frozen shoulder so it is important to confirm the diagnosis before deciding on a treatment strategy.

Early diagnosis and treatment of frozen shoulders can help prevent long-term pain and stiffness.

How long will a frozen shoulder last?

If left untreated a frozen shoulder will get better on its own but recovery can be slow taking anywhere between 18 to 36 months! The slow rate of recovery from this sometimes disabling condition can be frustrating for you and your healthcare professional.

Early interventions will often reduce pain and restore function within a year or less.

How do you treat a frozen shoulder?

Treatments are focused on relieving pain and restoring the shoulder's normal range of motion.

• Simple measures such as using hot and cold compresses, oral analgesia, and range-of-motion exercises are the first line of treatment.
• Corticosteroid/"cortisone" injected into the joint to address the pain associated with shoulder inflammation.
• Hydrodistention/hydrodilatation procedure - injecting corticosteroid/"cortisone" directly into the shoulder joint along with a moderate volume of saline fluid to expand the joint capsule to address the shoulder pain and capsule stiffness respectively. Complimented with physical therapy this has been proven to reduce pain and a faster recovery.
• Surgery -  Using key-hole surgery a shoulder surgeon can perform precise cuts to release the joint capsule from the inside. This is reserved for cases with the most severe movement limitation or those that don't improve despite all efforts.

If you are struggling with shoulder pain that is not improving make an appointment to see Dr. Ade.