Frozen Shoulder, also called adhesive capsulitis, is a painful condition characterised by stiffness and pain in your shoulder joint which gradually worsens over time. There are three distinct stages to the condition – the freezing stage, frozen stage and thawing stage. It normally resolves by itself over time (12-18 months) however sometimes the symptoms can last longer or become very severe. In such cases you may require treatment. Surgery is normally only used as a last resort.
Causes of Frozen Shoulder
A frozen shoulder occurs when the capsule of connective tissue surrounding your shoulder joint thickens and becomes tight, restricting the joint’s natural movement. The precise causes aren’t completely understood although certain factors increase your risk of developing a frozen shoulder. These include recovering from certain types of medical conditions or medical procedures that prevent you from moving your arm freely. For example, if you’ve fractured your arm or sustained a rotator cuff injury, or if you have diabetes, cardiovascular disease or Parkinson’s disease you may be more likely to develop a frozen shoulder. For this reason, if you have an injury that makes it difficult for you to move your shoulder, it’s important to discuss with your doctor what exercises you can do to maintain movement in the joint to help prevent a frozen shoulder. The condition is most common in people aged 40 and over, particularly women.
Symptoms of Frozen Shoulder
The symptoms of a frozen shoulder change as the condition develops.
- During the freezing stage your shoulder’s range of movement diminishes and you experience pain if you try to move it. It may also be painful at night, which can interfere with sleep.
- During the frozen stage the pain may lessen but your shoulder normally becomes stiffer making any type of movement difficult.
- During the thawing stage, symptoms gradually diminish and the range of motion in your shoulder improves.
Diagnosis of Frozen Shoulder
During a physical examination your doctor will ask you to make certain movements to assess the range of motion in your shoulder. You may also require a diagnostic test, such as an MRI scan or X-ray to rule out other conditions.
Treatment of Frozen Shoulder
Treatment for frozen shoulder normally focuses on minimising the pain using painkillers and anti-inflammatories and carrying out regular exercises to support you to recover as much movement in your shoulder as possible. In some cases, you may be offered an injection of steroids into the joint to help relieve pain and inflammation. Sometimes injecting sterile water into the joint capsule can help to stretch tight tissues. Rarely, surgery is needed to remove scar tissue and adhesions from inside the shoulder joint. This is normally performed arthroscopically (using keyhole surgery).
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