Frozen Shoulder Treatment

What is a Frozen Shoulder? 

A frozen shoulder, or adhesive capsulitis, is a condition that causes the shoulder to become stuck in one place. It happens when the connective tissue surrounding the shoulder, which keeps all its components together, becomes thick, restricting shoulder movement. 

The causes of frozen shoulder are not quite known. The condition usually starts mildly but can progress to become quite painful, requiring frozen shoulder treatment.

Anatomy of the Shoulder

Our shoulder is a joint where three bones come together: the upper arm (humerus), shoulder blade (scapula), and collarbone (clavicle). These three bones are held together by the shoulder capsule. When the tissue of the shoulder capsule becomes inflamed, the capsule thickens, leaving little room for the shoulder bones to move.

The result is a stiff and painful shoulder joint. Because using the shoulder becomes increasingly unbearable, its movement is resisted, causing it to become even more stuck. Ordinary tasks like getting dressed can become increasingly challenging and painful.  

Frozen Shoulder Symptoms

The most common symptoms of a frozen shoulder are severe pain, stiffness and limited range of shoulder movement. The condition can present in both shoulders but not usually at the same time.

Sure signs of a frozen shoulder are difficulty with routine tasks like:

• Dressing and undressing
• Taking a bath
• Getting in and out of a car and driving
• Getting something from a top shelf
• Taking hold of something slightly out of reach

Symptoms are categorised into three stages according to their severity. These stages and their duration are not the same for all patients.

What Causes Frozen Shoulder?  

Research has not identified clear causes for frozen shoulder, but health experts have singled out risk factors for developing the condition. These include:

• Age and gender – people older than forty are more likely to develop frozen shoulder which is more common among women than men.
• Neglecting physical exercise after an injury or a bout of shoulder tendinitis. 
• Prolonged forced immobility of the shoulder due to an injury or surgery.
• Immobilising the shoulder in a sling for days and leaving it like that.
• Rotator cuff problems can cause a frozen shoulder.
• Certain health conditions, including thyroid disorders, diabetes, Parkinson's disease, and tuberculosis.

Frozen Shoulder Stages

Stage 1

Stage 1 is referred to as the "freezing" stage. During this stage, stiffness in the shoulder sets in with an accompanying increase in pain. The shoulder becomes harder to move. This stage, like the others, varies from patient to patient, lasting from six weeks to nine months.

Stage 2

This is the so-called "frozen" stage. During this stage, the shoulder becomes almost totally immobilised, making routine tasks and daily activities very challenging, even impossible at times. The pain level stays mostly the same. This stage continues for two to twelve months.

Stage 3

Referred to as the "thawing" or recovery stage, this is when things start getting better. The stiffness eases, and the pain gradually dissipates. The individual gradually regains movement of the shoulder. Recovery takes place over some months. Full recovery can take up to two years.

Treatment for a frozen shoulder during all these stages is necessary to ensure timely and effective recovery.

How Is a Frozen Shoulder Diagnosed?

To diagnose your condition, a shoulder pain specialist will ask questions about your symptoms and carry out a physical exam. After discussing your symptoms, the doctor will test your active and passive range of movement.  

• The doctor will ask you to move your shoulder and arm to determine your range of movement – your active range of movement.
• The doctor will move your arm to see how far it will go in any direction, testing your passive range of motion.

If both types of motion are limited, a frozen shoulder diagnosis will be made. The doctor may order advanced imaging tests like magnetic resonance imaging (MRI) and ultrasound to confirm or eliminate other issues, such as arthritis or a rotator cuff tear. Typically, such tests are not necessary for a frozen shoulder diagnosis.