Frozen Shoulder

What is a frozen shoulder?

The shoulder is a complex joint, that sacrifices stability for great ranges in movement. The term frozen shoulder or adhesive capsulitis refers to inflammation, scarring and tightening of the connective tissue (ligamentous capsule) surrounding the shoulder joint. This results in pain and a noticeable loss of shoulder movement.

Causes

The cause of frozen shoulder is not yet fully understood. Some risk factors that have been associated with frozen shoulder include:

• Diabetes mellitus (with a prevalence up to 20%)
• Stroke
• Thyroid disorders
• Previous Shoulder injuries
• Dupuytren’s disease
• Parkinson disease
• Cancer
• Complex regional pain syndrome (CRPS)

Frozen shoulder occurs four times more often in females than males. It is most common in middle aged people 40 to 60 year of age. In the early stages this condition can resemble other shoulder conditions, so getting the right diagnosis is important for early intervention.

Symptoms

Frozen shoulder causes pain, stiffness and a loss of movement in the shoulder joint. The pain may be aching, dull or stabbing, and is usually felt deep in the shoulder and over the outside of the upper arm. The intensity and experience of your pain may vary from day-to-day depending on how you use your arm. Patients may particularly experience pain with motions required for grooming, performing overhead activities, dressing, and reaching behind the back or for the seatbelt. You may also experience pain at night or upon waking in the morning. These symptoms develop gradually causing a progressive loss in the range of movement of the shoulder. Stretching of these adhesions is not bad for you but may aggravate your pain.

Treatment

Treatment consists of many options, the first being a tailored regime of physio for frozen shoulder. This will most commonly be aimed at reducing your pain and improving your shoulder range of movement. It may involve the use of anti-inflammatory medications, shockwave therapy, dry needling, heat, ultrasound, stretching, strengthening and range of motion exercises. Our physiotherapists also provide expert hands-on manual treatments for soft tissue mobilisation to complement the exercise program. If you are not improving, your physiotherapist may refer you to a shoulder orthopaedic specialist, for their opinion. Following any surgical intervention, follow up physiotherapy is highly recommended for optimal outcomes.