Frozen Shoulder

Frozen shoulder on the insie

Let’s take a look at frozen shoulder.
AKA adhesive capsulitis.

Frozen shoulder is a chronic shoulder condition typically lasting 1.5 – 2 years; but can be triple that. It is characterised by both pain and restricted movement. The cause is often unknown, though it is related to immobility of the shoulder (eg after keeping your arm in a sling), previous injury to the shoulder, and to diabetes. The process is one of inflammation and contraction of the shoulder capsule, often with some scar formation within the joint itself.

Classically, frozen shoulder goes through three phases                               

Freezing/painful phase: Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption which may last anywhere from 3-9 months.

Phases of frozen shoulder

Frozen/stiffening phase: Pain starts to subside, progressive loss of glenohumeral motion in capsular pattern. Pain is apparent only at extremes of movement. This phase may occur at around 4-6 months and can last for about 12 months.

Thawing/resolving phase: Spontaneous, progressive improvement in functional range of motion which can last anywhere from 1 to 4 years.

Conservative management of frozen shoulder does not really offer a cure, or reduce the duration; but attempts to reduce the severity of the symptoms – both pain and freezing; and is based around mobilisation, massage, stretching and strengthening. NB: because the goal of conservative management is for symptom reduction, not cure – it is impossible to know for sure if it is working or not.

Medical management of frozen shoulder is based around steroid injection to reduce inflammation, or manipulation under anaesthetic to break down scar tissue.

#FrozenShoulder #AdhesiveCapsulitis #ShoulderPain

Anatomy of a frozen shoulder

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2 thoughts on “Frozen Shoulder

  1. My pain relief for frozen shoulder is the magic effect of ultrasound. Mechanical vibration to produce a slight skin massage, deep-warm by penetration of the subcutaneous 5 cm, and bubble wash.

    1. I’m currently re-assessing my opinion on ultrasound. Along with many others, I essentially binned it as a treatment regime a few years ago when it was found to be equally effective whether turned on or not. I think I was too quick and knee-jerk in my reaction there, and need to look at it much more in terms of dosage and condition.

      That’s the problem with research that essentially looks at a treatment regime of 1-2 sessions – it can produce startling conclusions, but the trial doesn’t necessarily reflect clinical practice.

      I’m not ready to start using it again yet; but I really need to get to the research and be more critical in my appraisal.

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