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Frozen Shoulder

Summary:


Frozen shoulder(also known as adhesive capsulitis), where the shoulder capsule tightens and stiffens up, causing pain and restrictions in shoulder movement and functions. This condition can last from weeks to months.




Contents

What is Frozen Shoulder?

Frozen shoulder, or adhesive capsulitis, is a condition where the shoulder joint has a loss of motion, i.e. ‘frozen’. The pattern of pain and restriction in movement is fairly characteristic. A classical frozen shoulder follows the following stages:

  • Freezing- starts off with a significant amounts of pain, but has acceptable amount of shoulder movement
  • Frozen- develops more stiffness and restriction in movement, but pain reduces
  • Thawing- gradual return of movement

What are the common causes?

Frozen shoulder can be classified into two categories:

  • Primary frozen shoulder
    • The primary cause of frozen shoulder is unknown. Today, no comprehensive etiological model exists! However, research has shown people with diabetes are more prone to develop frozen shoulder
  • Secondary frozen shoulder
    • Clear evidence of a trauma and usually involves structural changes within or adjacent to the joint, such as fractures and tendon injuries

By and large however, frozen shoulder can occur without any known cause

What are the signs and symptoms?

These are possible signs of frozen shoulder:

  • Loss of normal ability to move in all directions, especially with lifting your arm up, reaching behind your back and/or behind your head
  • Painful movement of the shoulder
  • 'Grinding' when moving your shoulder

What are the risk factors?

  • Traumatic shoulder injury
  • Prolonged immobility of the shoulder
  • Post surgery (especially in after shoulder reconstruction or mastectomy)
  • Diabetes

What types of treatment are available?

Medication

  • Anti-inflammatory medication during the initial stage

Physiotherapy

  • Reduce pain using modalities such as ice, heat or interferential current therapy
  • Improve range of movement through mobilisation,exercises and eventually regain functional movement
  • Improve muscle strength and control

Surgical

  • For patients who do not response to conservative treatment, doctor might suggest surgery e.g. manipulation under anesthesia to help to increase range of movement. For further information, please discuss with your orthopaedic doctor

Prognosis

  • If left alone it takes up to 2 years to resolve with some complications such as weakness, and reduction in range of movement reduction
  • Factors affecting recovery include
    • Severity of the frozen shoulder
    • Compliance with exercise program

How can I prevent it?

  • Unfortunately you cannot prevent frozen shoulder from happening but you may minimize the complications by doing the exercises taught regularly
  • The condition is such that you will have recurrences of stiffness and twinges of pain on and off. Continue your exercises during these times only as pain allows

What can I do to help myself?

  • It is important to do your shoulder rehabilitation exercises as prescribed by your physiotherapist. Please consult your health care provider, before you start any form of self exercise and treatment
  • Engaging in the exercises diligently can help with the treatment of the injury

FAQ

1. When can I return to my sport or activity?

  • Everyone recovers from injury at a different rate
  • In general you should be able to trial a return to normal or vigorous activity when
    • Your injured shoulder has almost full range of movement without pain
    • Your injured shoulder has regained normal strength compared to the uninjured shoulder


- Last updated 2 Dec 2011,3:50 pm




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