What is Frozen Shoulder?
Frozen shoulder, which is also known as adhesive capsulitis, is a condition which affects your ability to move the shoulder. Usually it occurs on one side, but in 1 in 5 persons it can affect the other shoulder as well. The medical term describes the changes to the capsule around the shoulder joint : adhesive capsulitis – adhesive meaning sticky, and capsulitis meaning inflammation of the joint capsule. The symptoms are due to the capsule becoming inflamed and 'sticky', making the joint stiff and difficult to move. This is not the same as arthritis, and other joints in the body are usually unaffected.
Frozen shoulder is uncommon among young people and is usually seen in those in the 40-70 year age range. There is a higher occurrence of this in women and in diabetics.
What does it feel like?
You may have pain and loss of motion during daily activities such as lifting your arm in front or sideways from your body, reaching your arm behind your body, or washing your hair or putting on clothes.
This condition has been described in three phases, and the symptoms may differ depending on the phase of the condition.
The Painful Phase
Gradual onset of aching shoulder.
Pain often worst at night and when lying on the affected side.
The Stiffening Phase
Stiffness occurs and you may have difficulty with daily tasks.
The Thawing Phase
Gradual improvement in range of motion with decrease in pain.
What can you do?
Seek medical advice if you think you may have this condition, as early intervention can prevent stiffness. Follow advice given by medical professionals, and it is important to do the daily exercises at home prescribed by the physiotherapist.
Try to keep the shoulder moving – even if it is just pendular swing exercises and stretching the arm onto a wall .
If movement is very painful, this should be under the guidance of a physiotherapist or doctor.
Application of a warm towel for 5-10 minutes prior to exercise may reduce the discomfort. If there is increased pain after the exercise, ice the painful area for 10 – 15 minutes.
What can we do to help you?
This condition is usually managed conservatively, with surgery as a last measure if other treatments do not allow you to resume your daily activities. Conservative treatments include physiotherapy, activity modification, pain medications, injection of corticosteroid medication into the joint, hydro-dilatation, or shoulder nerve block.
What does surgery involve?
Surgery may be performed in some cases, following failure of conservative treatment methods. Arthroscopic capsular release is the technique used most often. This involves dividing the thickened shoulder capsule. Surgery is followed by an aggressive rehabilitation protocol to restore the range of motion.