By definition frozen shoulder is an idiopathic (cause unknown) condition of the shoulder joint which is characterised with extensive pain and a contracture of the joint capsule itself.
The health industry is still searching for the exact cause and studies are constantly being undertaken for both cause and management of this condition. We do know that it involves a hyperplastic fibroplasia (more cells that normal) and excessive collagen secretion which leads to contractures of the joint capsule.
The frozen shoulder has 3 stages
Painful – Pain occurs in movement of the shoulder and range starts to become restricted
Frozen – Shoulder pain typically tends to decrease but the range of the shoulder reduces dramatically
Thawing – This is where you begin to get your range of motion back.
Signs and Symptoms
Frozen shoulder is seen most commonly in the age bracket of 40-60 and is twice as common in males. Less than 2% of the population will experience some level of frozen shoulder in their lifespan, however that increases to 11% in diabetics and those with hyperthyroidism. You are also more likely to suffer if you have had shoulder trauma and/or extended periods of immobility of the shoulder.
Potential differential diagnoses for the shoulder not moving can be radicular nerve pain, thoracic outlet syndrome, rotator cuff or labral tears and calcification of tendons.
Treatment of frozen shoulder
Range of motion exercises and stretching are the fundamental part of treatment, we have to encourage the shoulder joint to move as much as possible. NSAIDS (anti-inflams) are used to help control pain levels as well as heat or ice. We’re looking to do as many of the usual daily activities that the shoulder will allow us, we need to keep the strength.
Unfortunately recovery is slow and frustrating, but it WILL get better! The usual time frame is between 6 and 24 months , 60% of cases will get better within that 2 year time frame.
Surgery is very rarely required and we don’t encourage it unless absolutely necessary. Corticosteroid injections have been used in the past but with very limited efficiency, one study showed that in 65% of cases the injection was inaccurate and missed where it needed to go.