Frozen shoulder, or adhesive capsulitis, is an extremely painful condition that results in loss of range of movement at the shoulder joint. A true frozen shoulder typically develops without any injury or reason, but stiff shoulders can also develop after an injury, surgery or a period of immobility.
The shoulder joint is encased within a joint capsule. The joint capsule is normally large and loose, which allows the shoulder joint to have a large range of movement. In frozen shoulders the capsule becomes thickened and inflamed, which causes the shoulder to become very painful and stiff.
The condition usually goes through 3 phases:
Freezing – pain begins to develop, and becomes more severe over time. Range of movement reduces progressively. This phase can last between 6 weeks and 9 months
Frozen- pain begins to subside but the shoulder remains stiff. This phase lasts 4-12 months
Thawing – the condition begins to resolve, with a gradual increase in range of movement over 12-42 months.
Misdiagnosis is common with frozen shoulders and getting an early, accurate diagnosis is key to accessing appropriate treatment. Yorkshire Shoulder Physiotherapy will be able to help you with this.
We still don’t fully understand the pathology of frozen shoulder, and the exact mechanism of why people develop frozen shoulders remains unclear. It typically affects people aged 40-60 years old. It appears to be more common in people with diabetes, high cholesterol, heart disease or thyroid problems
Frozen shoulders tend to resolve without treatment over time. They have usually improved significantly 2-4 years after onset. There is no cure for a frozen shoulder, but there are several treatment options available to try to speed up the resolution.
Different treatments are useful at different stages of this condition. Yorkshire Shoulder Physiotherapy will be able to advise you about which treatments you may find beneficial once a full assessment has taken place.
Over the counter pain relief can be useful to manage the pain. If you are concerned or unable to take over the counter pain relief then seek advice from your GP or pharmacist.
Different physiotherapy treatments are useful at different stages of this condition, potential treatments include soft tissue or joint mobilisations to reduce pain and restore range of movement, as well as exercises to improve range of movement and strength.
Steroid Injections: These may be useful in the early freezing stage to reduce pain and in some cases can prevent the condition from progressing.
Hydrodilatation Injections: This is a technique whereby a large volume of fluid is injected, under x-ray or ultrasound guidance, into the joint aiming to stretch the joint from the inside. This procedure is less invasive than surgery and many people find it beneficial to reduce pain and improve shoulder range of movement. Should you wish to consider this treatment we can refer you to a local orthopaedic specialist.
Some people chose to have a surgical intervention to surgically release the joint capsule, aiming to improve range of movement. Should you wish to consider surgery we can refer you to a local orthopaedic specialist.
Physiotherapy treatment is vital following either a hydrodilatation injection or surgery and should begin within a few days of the procedure.