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Frozen Shoulder

Also known as: adhesive capsulitis

What is it?

Frozen Shoulder is an extremely painful condition in which the shoulder is completely or partially unmovable. Frozen shoulder often starts out of the blue, but may be triggered by a mild injury to the shoulder. The condition usually goes through three phases, starting with pain, then stiffness and finally a stage of resolution as the pain eases and most of the movement returns. This process may take a long time, sometimes as long as two or more years.

Frozen shoulder may be associated with diabetes, high cholestrol, heart disease and is also seen in patients with scar tissue in their hands, a condition called Dupuytren¹s contracture. It may follow an injury to the shoulder or surgery. 

The lining of the shoulder joint, known as the capsule, is normally a very flexible elastic stucture. It's looseness and elasticity allows the huge range of motion that the shoulder has. With a frozen shoulder this capsule (and its ligaments) becomes inflamed, swollen and contracted. The normal elasticity is lost and pain and stiffness set in.

click for larger image

Three stages of development:

Typical frozen shoulder develops slowly, and in three stages.:

• Stage One: Pain increases with movement and is often worse at night. There is a progressive loss of motion with increasing pain. This stage lasts approximately 2 to 9 months.
• Stage Two: Pain begins to diminish, however, the range of motion is now much more limited, as much as 50 percent less than in the other arm. This stage may last 4 to 12 months.
• Stage Three: The condition may begin to resolve. Most patients experience a gradual restoration of motion over the next 12 to 42 months
• Surgery may be required to restore motion for some patients, as most people never regain full shoulder motion.

Treatment

Physiotherapy – to prevent any further stiffness and regain range of motion

Painkillers and anti-inflammatories

Injections – reduce inflammation and provide pain relief

Surgery – Surgery has been shown to be of benefit in both the early and later stages of a Frozen Shoulder. It is excellent for both pain relief and restoring movement, although intensive physiotherapy is essential after the surgery. This involves a manipulation of the shoulder under anaesthetic for most cases. Some people may require surgical release of the tight shoulder capsule done with keyhole (arthroscopic surgery)

Prevention

Largely unknown. However, since frozen shoulder may set in as a result of underuse or immobilization of the shoulder, it is important not to neglect a painful injury as it may lead to stiffness.

• Frozen Shoulder in the Education Section
• Latest News & Research on Frozen Shoulder
• Patient Experiences

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