A frozen shoulder – also called adhesive capsulitis – causes the shoulder joint to become stiff and painful and makes it difficult to use the shoulder joint normally. Often the symptoms will improve on their own, however it can be a lengthy process taking between one and three years.
The good news is that there are treatments available that can relieve symptoms and support your recovery. Your orthopaedic surgeon will be able to discuss these in more detail with you and advise on the best treatment plan.
Treatments for frozen shoulder
We normally recommend a combination of approaches to manage the pain of frozen shoulder and encourage as much movement in the joint as possible. A treatment plan might involve:
- Painkillers and anti-inflammatories to relieve pain and reduce inflammation in the affected joint. Other at-home remedies include applying heat or cold to the shoulder to ease symptoms or using a TENS machine, which delivers a tiny electrical current that may help to relieve pain.
- Physiotherapy can help you to regain movement in your shoulder by providing a range of stretching and strengthening exercises.
- Injections of corticosteroids into the shoulder joint – these can be particularly effective if administered soon after the condition first occurs, helping to relieve pain and making it easier to move the shoulder.
- Hydrodilatation is a surgical procedure which may be combined with a steroid injection. It involves injecting sterile water into the joint capsule to stretch the tissues which become very tight when you have a frozen shoulder.
- Surgery for frozen shoulder is not normally needed. However, in severe cases you may be offered shoulder manipulation under general anaesthetic to loosen the tightened tissue or arthroscopic (keyhole) surgery to remove any scar tissue that has developed.
What causes a frozen shoulder?
The precise causes of frozen shoulder are not fully understood. A capsule of connective tissue surrounds the shoulder joint. When you have a frozen shoulder this capsule thickens and tightens, restricting movement of the shoulder. There are three stages to a frozen shoulder:
- The freezing stage, which generally lasts between two and nine months and is associated with increasing pain when you move your shoulder. This pain may also make it difficult to sleep.
- The frozen stage, which leads to the shoulder becoming stiffer and less mobile, although the pain may start to ease slightly.
- The thawing stage is when the shoulder may start to move a little more freely again. This can take between a few months and two years.
You are particularly at risk of developing a frozen shoulder if you are forced to keep your shoulder immobilised for an extended period of time – for example if you undergo shoulder surgery – or you fracture your arm, tear your rotator cuff or experience a stroke. The condition is most common in people over the age of 40, especially women. Certain diseases may also increase your susceptibility, including diabetes, cardiovascular disease, Parkinsons, hyperthyroidism or hypothyroidism.
Diagnosing a frozen shoulder
You will be given a physical examination and asked to move your arm so the doctor can assess your range of movement and how much pain you are experiencing. You may be given an X-ray, MRI or ultrasound scan to rule out other possible causes of shoulder pain, such as rotator cuff injury.
Can frozen shoulder be prevented?
It is not possible to prevent a frozen shoulder in every case. However, if you undergo shoulder surgery or break your arm, it is important to keep exercising the affected arm to reduce your risk of developing a frozen shoulder. A physiotherapist will be able to recommend the best exercises to maintain a good range of motion in your shoulder.
If you are experiencing shoulder pain and would like to discuss a possible diagnosis or treatment options, contact us for expert advice.
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