What is a frozen shoulder and how should it be treated?

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Frozen shoulder is a condition in which your shoulder becomes painful and stiff and can sometimes last for months or even years. It’s sometimes referred to as adhesive capsulitis or shoulder contracture, and it’s not always clear why it happens. 

The stiffness and pain caused by a frozen shoulder can impact your day-to-day life and leave you struggling to carry out everyday activities. Frozen shoulder pain often gets worse over time, so the earlier it is diagnosed and treated, the better, as it will help to prevent long-term pain and motility issues. 

Let’s take a closer look at what causes a frozen shoulder and how it can be treated. 


What causes frozen shoulder?

A frozen shoulder is caused by the thickening and inflammation of the flexible tissue surrounding your shoulder, also known as a capsule. The capsule around the shoulder begins to form bands of scar tissue inside it when a shoulder is frozen, which causes it to swell, thicken and tighten. This limits the amount of space there is for your upper arm bone in the joint, thus reducing overall movements.

Doctors don’t fully understand why this happens, but certain conditions and situations can increase the risk of developing a frozen shoulder, such as the following: 

  • A previous shoulder injury or surgery
  • A rotator cuff injury
  • Diabetes
  • Dupuytren's contracture - this is a condition in which small lumps of thick tissue form in the hands and fingers
  • Health conditions, including heart disease and stroke 


Symptoms of frozen shoulder 

There are three stages in which frozen shoulder symptoms tend to develop. These are: 

  • Freezing stage: this is where any movement causes shoulder pain, and movements become limited. This stage lasts for around 2 to 9 months. .
  • Frozen stage: during this stage, the pain may decrease, but the shoulder becomes a lot stiffer and more difficult to use, so movement may be limited. This stage lasts from 4 to 12 months. 
  • Thawing stage: this is when symptoms begin to improve, and the condition of your shoulder improves. This stage can last from 5 to 24 months.


How is a frozen shoulder treated?

Treating a frozen shoulder will depend on the stage of the condition and the severity of your individual situation. 

Sometimes, a frozen shoulder may heal on its own and get better over time without any treatment, but recovery in these scenarios is often much slower and can take at least 18 to 24 months. 

There are several different options when it comes to frozen shoulder treatment, each of which aims to reduce stiffness and pain and help increase your shoulder’s movement. Some of these treatments can be: 

  • Painkillers – If you’re in pain, your doctor will prescribe you painkillers such as paracetamol, codeine, or ibuprofen.
  • Corticosteroid injections – If painkillers aren’t making much of a difference for you, you may be offered a corticosteroid injection in your shoulder joint. These contain medicines that help reduce pain and inflammation and can increase your movements but will not cure the condition. 
  • Shoulder exercises and physiotherapy – Frozen shoulder can limit your movements as the area tends to get very stiff, so doing gentle stretches and exercises is a good idea. If this is too painful for you, you may be able to see a physiotherapist who will help with stretching exercises, massages, and thermotherapy with warm or cold temperature packs
  • Surgery – It’s very uncommon for surgery to be done on a frozen shoulder, but it is offered to some people who have had severe symptoms and unsuccessful treatments. You may then be referred to an orthopaedic surgeon who may perform any of the following:
    • Manipulation under anaesthetic: This is a procedure where your shoulder will be moved in a controlled way to stretch the sleeve (shoulder capsule) surrounding the shoulder joint.
    • Arthroscopic capsular release: This is a type of keyhole surgery conducted under general anaesthetic, where a few small incisions are made around your shoulder. A thin tube with a light and camera is inserted into one of the incisions, and a special probe emitting high-frequency radio waves is inserted into another. This is then used to divide or cut out the thickened parts of the shoulder capsule to open it up.
    • Arthrographic distension (hydrodilatation): This is less commonly used but may be recommended to you. This procedure involves using x-rays or ultrasound to guide an injection of fluid into your shoulder, filling the joint and stretching out the capsule.

The treatments described above can be quite effective in helping to reduce pain and improve shoulder movements. The treatment you are offered will depend on your individual situation.


Frozen shoulder treatment at Ramsay Health Care

Here at Ramsay Health Care, we have friendly and professional staff, including expert orthopaedic surgeons, state-of-the-art hospitals with advanced diagnostic equipment and excellent physiotherapy services to aid rehabilitation for your shoulder injury. Find out more about our services for frozen shoulder treatment and rotator cuff surgeries, or contact us today to make an appointment with a specialist.

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