The medical name for ‘Frozen Shoulder’ is adhesive capsulitis. ‘Adhesive’ refers to the stiffness and reduced movement that occurs in this condition, and ‘capsulitis’ refers to inflammation of the shoulder’s joint capsule. This is the thin lining that wraps around the shoulder joint.
We do not fully know what causes this condition. Sometimes a specific event will happen, such as a fall or bump, which causes ‘post-traumatic frozen shoulder’, though most of the time there is no obvious cause.
Frozen shoulder is quite common in people aged 40-60, is more common in women, and is more common in people who have diabetes, cardiovascular disease, or thyroid disease.
About 10% of people can expect to experience the same symptoms in their other shoulder in the future. This risk is higher in people with diabetes.
People often experience significant pain and very restricted movements. The pain can last for between two and nine months and unfortunately it can take anywhere between a year and four years to fully resolve.
The shoulder joint capsule thickens over time which limits movement of the shoulder. When the symptoms start to improve it tends to be a slow process. Your shoulder may always have some restriction of movement in the future. Although the pain usually gets better, it may never go away completely.
Symptoms may include:
No one treatment has been shown to ‘cure’ a frozen shoulder and on average a frozen shoulder can last about two and a half years.
The aims of treatment are:
Most treatment options are about pain control, accepting the limitations of the shoulder and waiting for it to get better.
Over the counter painkillers like paracetamol or ibuprofen will ease the pain, but need to be taken regularly in order to control the pain. Follow the instructions on the packet and discuss using them safely with a pharmacist or GP, especially if you have any underlying health conditions.
https://www.nhs.uk/medicines/paracetamol-for-adults/
https://www.nhs.uk/medicines/ibuprofen-for-adults/
It important to remember that shoulders are designed to move, and inactivity can cause further problems with the tissues around the joint. With a frozen shoulder pain does not equal damage. It is therefore important to maintain movement within the limits of your pain.
However, you may want to avoid doing tasks that aggravate your pain too often. Adjusting how you do certain tasks can help manage your pain, for example, putting your sore arm in first to a jumper or jacket and taking it out last.
Stand with your feet hip width apart and leaning forward onto your good arm. Make sure your free arm is fully relaxed. Slowly swing your affected arm forwards and backwards in a comfortable range 10-15 times, and then in small circles clockwise and anti-clockwise.
The British Elbow & Shoulder Society have created a video with useful exercises and information about frozen shoulder.
If your symptoms aren’t improving after trying this advice for a couple of months or your pain is severely impacting on your ability to function, you should seek support from a healthcare professional. They may recommend referral onto a physiotherapist or other treatment.
Steroid injections into the joint (with or without local anaesthetic) may be offered. It can be difficult to predict how much this might help and any relief this gives is generally short term.
A physiotherapist will advise you on when to re-start exercises after you receive the steroid injection. A second injection may be required in a small number of cases.
Injections may not be suitable for every person.
These procedures are similar to each other and involve injecting a volume of fluid into the affected shoulder joint to stretch the capsule.
Not all people are suitable for these procedures, and these treatment options are not always available in all hospitals. The results are variable and not everyone gets significant improvement from them.
This involves direct physical manipulation of the shoulder under general anaesthetic to hopefully improve the movement.
An arthroscopic (keyhole) capsular release uses a camera in the joint to guide the release (cutting) of some of the thickened joint capsule.
Surgery is not a reliable way to make the frozen shoulder go away but can sometimes help. If the pain associated with frozen shoulder remains severe for a long time, surgery may be discussed as an option.