Frozen shoulder a term often used for anyone with a painful and stiff shoulder. However there is a lot of confusion about the exact diagnosis, how long it lasts and what the best treatments are.
A Frozen shoulder is also known as Adhesive Capulitis. The cause of the pain and loss of movement is due to inflammation and fibrosing (tightening up) of the Capsule (the fibrous soft tissue which surrounds the shoulder joint)
FREEZING STAGE
A true frozen shoulder usually starts with gradually increasing pain and restriction of movement. There is no sudden onset of pain, no injury or event to explain it, it just gradually appears and steadily increases.
During this stage the pain can become very severe and can seriously affect sleep and restrict normal daily living.
FROZEN STAGE
The second stage is where the shoulder movement is severely restricted. Elevation of the arm is usually limited to no higher than shoulder level and commonly people have problems with rotation movements such as placing the hand behind head or back.
Tasks such as brushing hair, reaching to the back pocket of your trousers and for women, doing up your bra, often become impossible. Pain at this stage may start to settle.
THAWING STAGE
The final recovery stage is when movement starts to return.
It can take anywhere from two to seven years to recover from a frozen shoulder. Occasionally full movement is not regained with some mild pain remaining. This however, does not usually give any significant functional disablility.
Although a frozen shoulder is thought to occur for no apparent reason, there is thought that a joint infection, inflammation, bleed, nerve malfunction or muscle degeneration could be the reason for a frozen shoulder to occur.
A Secondary Frozen shoulder is one that has come about secondary to an existing problem such as severe neck and arm pain or arthritis, or following trauma or an injury. This can also occur following mastectomy operations.
What you can do to help treat your frozen shoulder
Physiotherapy
Physiotherapy can help you to understand your problem, relieve pain, increase joint movement and most importantly assist you in self management of the problem.
The Assessment involves a brief discussion about your symptoms and a thorough assessment of the area affected. Physiotherapy can help diagnose your problem.
Classically signs (what the examiner finds) found will include a restriction in the movements of the shoulder, both active (the person moving themselves) and passive (the joint being moved by someone else). Upward motion is usually less than 100 degrees (i.e. not far above shoulder level) and the arm cannot be turned outward more than 30 degrees.
You will receive treatment specific to your problem.
The aims of treatment may include:
- Reduce pain and stiffness, by treatment such as massage, mobilisations to the joint and surrounding soft tissue and muscles, electrotherapy (including interferential, ultrasound and in severe cases TENS), acupuncture.
- Taping may be used to assist movement of the joint and help encourage muscle work.
- Provision of specific exercise to help maintain or improve the movement and eventually strengthening exercises to regain movement and recover muscle strength.
- To help you to understand the condition and how to manage it.
Occasionally physiotherapy may not help and in these cases it is important to continue shoulder stretches. In the event that Physiotherapy does not help, your Physiotherapist will discuss further options.
Occasionally in the more severe cases, referral to a orthopaedic consultant is needed. A local shoulder steroid injection may be given or a manipulation under anaesthetic (MUA).
For more information or advice please get in touch with us.
For physiotherapy appointments and home visits and to book pilates please call Kate on 07956 372891 or email: katewhiteland@gmail.com