Frozen Shoulder
Frozen shoulder or 'Adhesive Capsulitis' is a common cause of shoulder pain in people aged between 40 and 60, with women affected more than men. Physiotherapy treatment is the first option for Frozen Shoulder treatment. Some evidence suggests that more aggressive shoulder mobilisation in conjunction with local anaesthetic and corticosteroid injections can provide shoulder pain relief and restore normal movement.
Common Frozen Shoulder signs & symptoms
Interestingly, the non-dominant shoulder appears to be affected more than the dominant shoulder. Those patients with frozen shoulder usually experience distinct phases with differing signs and symptoms.
First phase - gradual onset of pain and loss of movement
During the first phase pain comes on slowly and leads to a gradual loss in shoulder movement. Some patients may not notice anything until they struggle to, say, fasten a bra or comb their hair.
Second phase - restriction of shoulder movement
Eventually, over the space of a couple of months, the pain becomes so severe that it interferes with sleep because there is an exquisite pain when attempting to lie on the affected shoulder.
The second phase can last for up to a year.
Final phase - gradual increase in shoulder range of motion
The final phase can last between 5 months and two years, although some patients can experience a more rapid recovery. During this time there is a gradual increase in shoulder range of motion.
What you can do
Ice therapy or hot packs can be effective to help pain relief, depending on personal preference. Pain relieving medication prescribed by a doctor is particularly helpful during the early 'freezing'' phase.
Physiotherapy treatment is the first option for Frozen Shoulder. The main aim of physiotherapy treatment is to gently stretch the shoulder joint capsule. This is achieved through performing passive mobilisations which are done at various points in the range of shoulder movement. In addition, the patient must keep up a regular active stretching program to gently improve shoulder range of movement. All this stretching should be pain free.
Ice therapy or hot packs can be effective to help pain relief, depending on personal preference.
Some evidence suggests that more aggressive shoulder mobilisation in conjunction with local anaesthetic and corticosteroid injections can provide pain relief and restore shoulder range of movement.
If the arm can't be lifted to the level of the shoulder after three months then manipulation under anaesthetic (MUA) by an orthopaedic consultant may be appropriate. Following the procedure, the affected arm is held 'abducted' away from the trunk in order to maintain range of movement. The day after the MUA, the patient must begin a series of active exercises to restore the full range of motion. If these conservative measures fail then surgery may be indicated to release the adhesions and restore range of movement.
It is important to avoid total disuse of the affected arm. This can lead to muscle wasting in the forearm and hand. This means that once the Frozen Shoulder pain resolves there will be a good level of function in the hand.
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