What is Frozen Shoulder
Frozen shoulder (ADHESIVE CAPSULITIS) is a common condition seen in about 3% of the population. The cause of this condition is unknown. It more common in women than men and in people over 40. Having diabetes or thyroid disease increases your risk. 10% of people will develop frozen shoulder in both sides. Most commonly it occurs spontaneously, however can occur after a traumatic event such as a fracture or shoulder surgery.
This condition causes shoulder stiffness (hence frozen shoulder) as well as pain with movements of the arm and particularly pain at night. The shoulder joint capsule stiffens and becomes inflamed. Once the condition settles it rarely recurs. In most cases this condition will recover by itself with minimal intervention. It can take up to two years for the condition to resolve and the reasons for this are not known.
Phases of Frozen shoulder
There are 3 distinct phases to a frozen shoulder:
1. FREEZING PHASE: This is the most painful phase that lasts 2 to 9 months (sometimes even longer in diabetics). Patients get pain at rest, with activity and also pain at night. There is significant restriction of motion.
2. FROZEN PHASE this is the progressive stiffness phase that lasts 3 to 12 months. Pain occurs only at the extremes of movement but the shoulder remains stiff.
3. THAWING PHASE this is the resolution phase where movements improve over a 12 to 24 month period. This phase is not typically painful.
Some people are left with a slight long term ongoing joint stiffness.
Frozen Shoulder Treatment
Physiotherapy treatment of Frozen shoulder
Physiotherapy can be helpful in the freezing phase of frozen shoulder. The therapy will aim to decrease the pain from the shoulder joint and deal with any subsequent muscle pain (which is common). The Physiotherapist will also provide you with some basic range of motion exercises to complete. These are not designed to increase your range of motion, but rather maintain the range of motion you have.
During the frozen stage Physiotherapy aims to maintain and monitor your range of motion.
Physiotherapy can shorten the thawing stage by strengthening the shoulder and giving your range of motion a little “push”.
Medical treatment of Frozen shoulder
There are several medical treatments available for Frozen shoulder, these include but are not limited to steroid injection, hydrodilatation, manipulation under anaesthetic. these are best discussed with your doctor. These treatments will not shorten the duration of your Frozen Shoulder, however they may give you more range while it recovers.
For more information please see Dr Doron Sher’s ( Shoulder surgeon) handout;