Frozen shoulder is the commonly used name for ‘Adhesive Capsulitis’, which is a condition that causes the shoulder to become very pain and stiff. This can sometimes occur following minor trauma to the shoulder, but often happens due to no apparent reason, which can be both confusing and frustrating for patients.
It affects 2-5% of the population, typically between 40 to 65 years of age, with certain risk factors such as:
- previous shoulder injury
- thyroid disease
How Does it Happen?
The shoulder joint, by design, is an incredibly mobile joint with a very large range of motion. The shoulder joint, like other joints in the body, is surrounded by a capsule, that allows this free range of motion. The capsule is also important in providing stability, sensory feedback, and aiding in lubrication of the joint. Tightening of this capsule due to adhesions, is what causes Adhesive Capsulitis.
The condition follows three distinct phases:
1. The Freezing Stage – This is where the joint gradually starts to stiffen over time. This initial stage is usually characterised by an achy shoulder at rest, very painful with movements, and difficulty sleeping due to the pain.
2. The Frozen Stage – This is the longest stage, and where the joint stiffness plateaus at it’s peak. This period is where people find greatest difficulty with performing daily tasks due to stiffness, but often the pain is less than the initial phase.
3. The Thawing Stage – Where the shoulder starts to gradually recover, and shoulder movement and function is restored.
The good news about frozen shoulder, is that for most people it will generally recover on it’s own over time. This can typically take anywhere from 9 months up to 3 years, with the average being about 18 months. Appropriate therapy is important in managing recovery.
What is the Best Treatment?
Current clinical guidelines for frozen shoulder suggest a combination of the following treatment:
Education – Understanding the nature of your pain, and what to expect in terms of time for recovery, can make managing it a lot easier.
Maintain Normal Activities – It is helpful to continue using the affected shoulder as much as possible. Not using the affected shoulder can further restrict free movement and increase sensitivity of painful structures within the joint.
Manual Therapy and Exercise – Treatment provided by your health practitioner can assist in speeding up the recovery time, and reducing pain as it naturally recovers. Treatments shown to be effective include specific exercises to improve range of motion and strength at the shoulder joint, and joint mobilisation and manipulation performed by your health practitioner.
Joint Injections – For some people, corticosteroid injections into the joint, can be very helpful, especially when combined with joint mobilisation and manipulation.
If you need more information regarding frozen shoulder, do not hesitate to contact us at the clinic on 9581 3331, and book an appointment to discuss what type of treatment is appropriate for you.
“Shoulder Pain and Mobility Deficits: Adhesive Capsulitis,” J Orthop Sports Phys Ther 2013;43(5):A1-A31. doi:10.2519/jospt.2013.0302.