Frozen Shoulder
Frozen shoulder (capsulitis) affects about 6% of the population, but can be more common among those with diabetes. Although it is uncommon for a frozen shoulder to return twice to the same shoulder, some patients may develop a frozen shoulder on the opposite side at some time in the future.
Frozen shoulder goes through three overlapping stages. In the early stages, pain may be significant, followed by increasing stiffness, and eventually movement returns as the frozen shoulder "thaws" out. The process can take between 1-3 years, but in many cases it will fully resolve.
Early (painful) stage
Patients often comment that there was no noticeable trigger event. Initially, they report pain in the shoulder, increasing with movement and often worsening at night, affecting their ability to sleep. This can last from 3-6 months.
Frozen stage
As pain settles, there is usually a gradual loss of movement in the arm. The time-frame for this stage can be variable, usually lasting around 3-6 months.
"Thawing" stage
Eventually, the movement begins to return. There is usually little, or no pain during this stage, and this is a good time to begin stretching the shoulder under the guidance of a physiotherapist if you haven't already been seen. Full movement may take another 3-6 months to return, or sometimes longer. In a small proportion of patients, 100% movement may not return, however any resulting stiffness is usually minimal and does not interfere with daily activities.
Early (painful) stage
Patients often comment that there was no noticeable trigger event. Initially, they report pain in the shoulder, increasing with movement and often worsening at night, affecting their ability to sleep. This can last from 3-6 months.
Frozen stage
As pain settles, there is usually a gradual loss of movement in the arm. The time-frame for this stage can be variable, usually lasting around 3-6 months.
"Thawing" stage
Eventually, the movement begins to return. There is usually little, or no pain during this stage, and this is a good time to begin stretching the shoulder under the guidance of a physiotherapist if you haven't already been seen. Full movement may take another 3-6 months to return, or sometimes longer. In a small proportion of patients, 100% movement may not return, however any resulting stiffness is usually minimal and does not interfere with daily activities.
What are the causes of frozen shoulder?
Frozen shoulder can be triggered by even a mild injury or trauma to the shoulder, but it is also associated with underlying health concerns such as high cholesterol, diabetes, heart disease, Parkinson’s, hyperthyroidism and hypothyroidism and a hand condition called Dupuytrens contracture.
The lining of the shoulder joint, known as the shoulder capsule, becomes inflamed, and begins to stiffen, restricting movement.
During your consultation at the Advance Physiotherapy, your symptoms will be discussed in full and your range of movement and degree of pain is assessed. In some cases, and x-ray may be helpful to help differentiate frozen shoulder from other conditions that can cause a stiff shoulder. Your physiotherapist will let you know if an x-ray is necessary.
Frozen shoulder can be triggered by even a mild injury or trauma to the shoulder, but it is also associated with underlying health concerns such as high cholesterol, diabetes, heart disease, Parkinson’s, hyperthyroidism and hypothyroidism and a hand condition called Dupuytrens contracture.
The lining of the shoulder joint, known as the shoulder capsule, becomes inflamed, and begins to stiffen, restricting movement.
During your consultation at the Advance Physiotherapy, your symptoms will be discussed in full and your range of movement and degree of pain is assessed. In some cases, and x-ray may be helpful to help differentiate frozen shoulder from other conditions that can cause a stiff shoulder. Your physiotherapist will let you know if an x-ray is necessary.
What are my treatment options for frozen shoulder?
For many patients, frozen shoulder will eventually resolve itself, but this may take 2-4 years from the initial onset of pain. During this period, the pain and lack of mobility can be problematic, leading many to seek treatment.
Treatment options include:
1. Do nothing. Take a 'wait and see' approach.
2. If pain is significant and affecting sleep and function, pain relief may be required. This may include:
- analgesics or anti-inflammatories (prescribed by your GP)
- an image-guided injection of corticosteroid (anti-inflammatory) into the shoulder joint. This has shown good results for improving pain (but not stiffness) in the early/painful stage. These can be repeated up to 3 times if they are helping. Your physiotherapist can refer you for this procedure if required.
4. If pain and/or stiffness are not showing improvements over time (usually after 1 year), orthopaedic evaluation may be required. A very small proportion of patients may need a minor surgical procedure to help restore movement if other treatments have been unsuccessful. Any surgery should be followed with physiotherapy for optimal success.
For more information on frozen shoulder and your possible treatment options, please get in touch to arrange a consultation.