Do you feel like your shoulder is suddenly beginning to stiffen up? Is washing your hair becoming harder by the day? Has a once healthy shoulder now deteriorated to the point that you’re unable to move it without pain? If you are experiencing any one of these issues, you could be experiencing a condition called frozen shoulder (or ‘adhesive capsulitis’ for all you scientists reading).
For many people with this condition, recovery can be a long and arduous journey. Finding an accurate diagnosis and treatment plan is an absolute priority. This article uses a physiotherapist’s perspective to create a simple guide to overcoming a frozen shoulder(s).
What is frozen shoulder?
Frozen shoulder or adhesive capsulitis is a condition where the shoulder joint suddenly becomes stiff and sore over several weeks or months. Many people usually won’t be able to pinpoint how it occurred. People with this condition often present with varying degrees of movement limitation and pain in the shoulder region.
A healthy shoulder can be described as a well-lubricated ball and socket joint. However, with frozen shoulder, numerous changes begin to occur inside. Contracture, or the narrowing of the space within the joint, begins to restrict movement. Inflammation and thickening of the inner lining. Restrictions of the supporting structures, such as muscle and ligament. These are the hallmark changes in a classic frozen shoulder.
Frozen shoulder causes
Despite ongoing research, there is currently no definitive evidence of any specific causes of frozen shoulder. However, there are certain situations where the risk of developing it can be greater. Examples of conditions or characteristics associated with a higher chance of frozen shoulder include:
- Being over the age of 40
- Long periods of shoulder stiffness or disuse (i.e. prolonged sling usage, reduced activity during winter)
- Thyroid issues
- High blood pressure
- High cholesterol
Frozen Shoulder Symptoms
The symptoms of frozen shoulder evolve and change over time. Fortunately, many people will recover from this condition, especially if the correct treatment is sought early. It can last between 9-15 months and for the majority of people present with 3 distinct phases of symptoms. Our table below showcases the main patterns of symptoms we see over the whole course of someone with a frozen shoulder.
|Classifications and Symptoms|
|Phase 1||Freezing – in this phase, patients will report pain, particularly at nighttime, more than anything else. While movement can be affected; it’s not the main problem.|
|Phase 2||Frozen – as the pain begins to settle, the shoulder enters the frozen phase. Stiffness in the shoulder starts to occur and is the most painful at the end limits of movement. Marked loss of shoulder movement can appear here.|
|Phase 3||Thawing – most people will see the most recovery in this stage. As pain and inflammation settle, the shoulder’s movement will begin to increase back to its original range.|
Frozen shoulder treatment
Everybody diagnosed with a frozen shoulder will experience different problems and recovery timelines. While some may recover spontaneously, others may need further medical interventions. That’s why the recommended treatment approach will vary greatly from person to person. However, most people will initially benefit from conservative treatment, including:
- Physiotherapy – Your physiotherapist will be able to diagnose, assess, monitor and treat your frozen shoulder. Examples of treatments that might be offered include dry needling, lifestyle strategies, hands-on techniques and corrective exercises to help improve your symptoms.
- Exercise physiology – Once appropriate, exercise physiologists use their advanced rehabilitation background to offer you an activity-based approach to improve shoulder flexibility and strength. Please refer to examples of some basic exercises in the ‘exercise’ section below.
- Medication – Medications can be helpful to reduce inflammation and pain, particularly in the early stages of the condition.
- Intra-articular injections – Certain injections into the joint, such as a hydrodilation or corticosteroid injection, may be beneficial for improving shoulder inflammation and stiffness. Having a chat with your GP and physiotherapist may be worthwhile before considering this option.
Although very uncommon, some people may require a surgical opinion. However, it’s important to emphasize that conservative treatment should always be trialed beforehand.
At Move Better for Life, we want to get to the root cause of your shoulder problems. If you’re struggling with stiffness, pain or reduced mobility, please contact us today. Our team of physiotherapists, exercise physiologists and occupational therapists will tailor a solution for you. For more information, please make a booking here.