Frozen shoulder: What is it and what are the best options for treatment?

Frozen shoulder or adhesive capsulitis is a condition characterized by progressive stiffening of the shoulder joint. The connective tissue or capsule surrounding the shoulder joint becomes inflamed and stiff, which causes pain and restricts movement of the shoulder.The exact causes of frozen shoulder are unknown but some people are at a higher risk of developing frozen shoulder. Things that increase your risk of developing frozen shoulder include:- diabetes- immobility: if you are immobile for a long time, for example following an illness this can increase your risk of developing frozen shoulder- shoulder or upper limb injury: this can be due to the fact that when you have an upper limb injury you may keep your arm still for longer periods of time increasing you risk for frozen shoulder- a history of frozen shoulder: If you’ve had frozen shoulder in one arm, unfortunately you’re more likely to develop the condition in your other arm.There are three main stages associated with frozen shoulder

• ‘Freezing stage’: pain and stiffness gradually start to build up. Pain can increase with reaching over head and the shoulder can be sore to lie on.
• ‘Frozen stage’: The shoulder becomes increasingly stiff. Tasks such as getting dressed can become difficult. The pain however, will normally reduce somewhat in this stage
• ‘Thawing stage’: Movement in the shoulder will gradually improve in this phase and pain will reduce. You will gradually be able to do more tasks using the shoulder

 Each stage can last for many months, with the whole process normally lasting 18-24 monthsSo what are the best options for treatment?Physiotherapy can be helpful for frozen shoulder. Treatment can include mobilisations to the shoulder, neck and upper back, trigger point dry needling or soft tissue massage to loosen the muscles of the shoulder and a stretching programme. If improvements are not seen, a specialist review may be useful. The specialist may undertake a corticosteroid injection to reduce inflammation and relieve pain. This can provide a pain free window in which to push stretching exercises. If this is unsuccessful, some people will undergo a surgery such as a manipulation under anaesthetic whereby the shoulder is moved and stretched while you are asleep. You will need follow up physiotherapy to maintain this increased movement. Although this is a painful and frustrating condition, in most cases symptoms will resolve after a period of 18-24 months. Contact us at our Dublin 4 clinic to find out more.