Frozen Shoulder is an extremely painful condition in which the shoulder is completely or partially unmovable (stiff). Frozen shoulder often starts out of the blue, but may be triggered by a mild injury to the shoulder. The condition usually goes through three phases, starting with pain, then stiffness and finally a stage of resolution as the pain eases and most of the movement returns. This process may take a long time, sometimes as long as two or more years.
Frozen shoulder may be associated with diabetes, high cholesterol, heart disease. It may follow an injury to the shoulder or surgery.
The lining of the shoulder joint, known as the ‘capsule’, is normally a very flexible elastic structure. It’s looseness and elasticity allows the huge range of motion that the shoulder has. With a frozen shoulder this capsule (and its ligaments) becomes inflamed, swollen, red and contracted. The normal elasticity is lost and pain and stiffness set in.
Typical Primary frozen shoulder develops slowly, and in three phases:
Freezing phase: Pain increases with movement and is often worse at night. There is a progressive loss of motion with increasing pain. This stage lasts approximately 2 to 9 months.
Frozen phase: Pain begins to diminish, however, the range of motion is now much more limited, as much as 50 percent less than in the other arm. This stage may last 4 to 12 months.
Thawing phase: The condition may begin to resolve. Most patients experience a gradual restoration of motion over the next 12 to 42 months
A frozen shoulder can be diagnosed in a clinic from your clinical signs and symptoms:
Unable to reach above shoulder height
Unable to throw a ball
Unable to quickly reach for something
Unable to reach behind your back eg bra or tuck shirt
Unable to reach out to your side and behind. eg reach for seat belt
Unable to sleep on your side.
If nothing is done most frozen shoulders improve significantly over 2-4 years after onset. However, the pain and limitations of the stiff shoulder generally require treatment. The treatment required depends on the severity of the pain and stiffness. These include:
Physiotherapy to prevent any further stiffness and regain range of motion
Painkillers and anti-inflammatories
Injections reduce inflammation and provide pain relief
Surgery has been shown to be of benefit in both the early and later stages of a Frozen Shoulder. It is excellent for both pain relief and restoring movement, with a success rate of 96% at 6 months. Intensive physiotherapy is essential after the surgery.
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