Frozen Shoulder

Frozen shoulder (or adhesive capsulitis) is a condition where the shoulder joint becomes painful and stiff. Frozen shoulder may develop after a relatively minor injury to the shoulder, but more often develops without an obvious cause.

The patient with a frozen shoulder initially reports a period – usually referred to as the “painful phase” – where their shoulder is painful at the extremes of movement, aches at rest and is uncomfortable at night. This is then followed by a progressive loss of movement, difficulty performing simple tasks and a loss of function that may last several months. This is known as the “freezing stage”. Eventually the shoulder movement begins to return and pain settles, otherwise known as the “thawing stage”.  The whole process may last 1 to 2 years on average and some people report more disability than others.

There is no hard and fast answer to this question. It appears that one possible cause of a frozen shoulder may be a previous, relatively minor trauma to the shoulder joint. This could be something as simple as reaching awkwardly for something on a high shelf or carrying something heavier than usual.

The pain is often not that noticeable at the time and many patients cannot recall any exact injury. It is suggested by some experts that even a small strain of the shoulder muscles can result in inflammation that may lead to the shoulder becoming painful and stiff. However, it is also known that frozen shoulder can develop in those with other health conditions such as diabetes. This suggests that the way diabetes affects the body, may also leave these patients vulnerable to soft tissue problems, such as frozen shoulder.

There is ongoing research into frozen shoulder to help us explain why some patients develop this and other patients don’t.

Frozen shoulder is more commonly seen in women than men (particularly those over the age of 50). It is also seen more often in people who are diabetic or those with a thyroid problem. The condition can affect between 2% and 5% of the population and can make simple activities, such as brushing your hair or getting dressed, painful and restricted.

At Pure, your Physio will take a detailed history of your symptoms followed by a thorough clinical examination to establish an informed hypothesis of the structures contributing to your pain and provide a working diagnosis. A fast and accurate diagnosis will mean that the most effective treatment and management plan can be implemented straight away, helping to achieve optimal outcomes. Your Physiotherapist will want to know how your condition is effecting you day to day so that your treatment can be tailored to your needs and will mean personalised goals can be established. Regular re-assessment will ascertain if your are making progress towards your goals and will allow adjustments to your treatment to be made.

The Physiotherapist at Pure will help guide you through the most appropriate treatment and management of your frozen shoulder. The physiotherapist may help work out a specific plan to modify activities which you may be struggling with due to your pain. The Physiotherapist can also answer any questions you may have about your pain, such as what is causing the pain and the likely recovery time with your rehabilitation programme. Your Physiotherapist at Pure will discuss pain relief options or other appropriate medication. This may help you achieve better results with your exercises if pain can be managed with medication.

It is very important that you continue to use your shoulder as often as you can (within the limits of pain) to maintain the movement that you have. Stretching, strengthening and mobility exercises are essential to maintain and restore movement of the shoulder and have been shown to lead to quicker recovery.

Your Physiotherapist at Pure can advise you on the best stretching, strengthening and mobility exercises for your shoulder. They can also give you advice on the level of pain to be expected or tolerated and how often the exercises would need to be performed.

Please find the patient resources section of our website where we have created a collection of recommended exercise programmes specifically for frozen shoulder. We advise consulting with your Physiotherapist prior to trying any of these exercises.

Manual therapy, a type of physiotherapy treatment in which the shoulder joint is mobilised with hands-on techniques, can help relieve pain and may lead to a better response to your exercise programme.

The Physiotherapist or Doctor may also suggest a steroid injection into the shoulder. A steroid is a powerful anti-inflammatory medication which is often combined with a local numbing agent. This can result in some temporary relief of your pain which may help you better engage with your exercises.