Frozen shoulder (sometimes called adhesive capsulitis) is a condition where a shoulder becomes painful and stiff. Shoulder movements become reduced, sometimes completely ‘frozen’. It is thought to be due to scar-like tissue forming in the shoulder capsule. Without treatment, symptoms usually go but this may take up to 2-3 years. Various treatments may ease pain and improve the movement of the shoulder.
WHAT ARE THE SYMPTOMS OF FROZEN SHOULDER?
The typical symptoms are pain, stiffness, and limitation in the range of movement of a shoulder. The symptoms typically have three phases:
· . This typically lasts 2-9 months. The first symptom is usually pain. Stiffness and limitation in movement then also gradually build up. The pain is typically worse at night and when you lie on the affected side.
· . This typically lasts 4-12 months. Pain gradually eases but stiffness and limitation in movement remain and can get worse. All movements of the shoulder are affected. However, the movement most severely affected is usually rotation of the arm outwards. The muscles around the shoulder may waste a bit as they are not used.
· . This typically lasts anywhere between five months and four years. The pain and stiffness gradually go and movement gradually returns to normal, or near normal.
Symptoms often interfere with everyday tasks such as driving, dressing, or sleeping. Even scratching your back, or putting your hand in a rear pocket, may become impossible. Work may be affected in some cases.There is great variation in the severity and length of symptoms. Untreated, on average the symptoms last 2-3 years in total before going. In some cases it is much less than this. In a minority of cases, symptoms last for several years.
WHO GETS FROZEN SHOULDER?
Frozen shoulder affects about 1 in 50 adults at some stage in their life. It most commonly occurs in people aged between 40 and 60. It is more common in women. It is more common than average in people who have diabetes and some other conditions, including overactive thyroid disease and Parkinson’s disease.
Either shoulder can be affected but most commonly it is the non-dominant shoulder. That is, the left shoulder in a right-handed person. In about 1 in 5 cases the condition also develops in the other shoulder at some stage.
: frozen shoulder is a form of arthritis and other joints are not affected.
WHAT CAUSES FROZEN SHOULDER?
The cause is not clear. It is thought that some scar tissue forms in the shoulder capsule. The capsule is a thin tissue that covers and protects the shoulder joint. The scar tissue may cause the capsule to thicken, contract and limit the movement of the shoulder. The reason why the scar tissue forms is not known.A frozen shoulder occasionally follows a shoulder injury. However, this is not usual and most cases occur for no apparent reason.
WHAT ARE THE TREATMENT OPTIONS FOR FROZEN SHOULDER?
The aim of treatment is to ease pain and stiffness. Also, to keep the range of shoulder movement as good as possible whilst waiting for the condition to clear. One or more of the following may be advised to help ease and prevent symptoms:
Paracetamol may be advised first to try to control the pain. Codeine is a stronger painkiller which may be used as an alternative to, or in addition to, paracetamol. Constipation is a common side-effect from codeine. You can take ordinary painkillers in addition to other treatments.
Examples of these include ibuprofen, diclofenac and naproxen. These drugs work by helping to ease pain and also by reducing any swelling (inflammation) in your shoulder. Anti-inflammatories are not suitable for everyone so please check with your pharmasist before starting on this treatment route.
These are commonly advised. The aim is to keep the shoulder from ‘stiffening up’ and to keep movement as full as possible. For most benefit, it is important to do the exercises regularly, as instructed by your osteopath.
Many people are referred to an osteopath who can give advice on the best exercises to use. These will be a key part of your treatment alongside techniques to improve movement and reduce pain. Osteopathic treatment can significantly reduce the recovery time for frozen shoulder.
A STEROID INJECTION
An injection into, or near to, the shoulder joint brings good relief of symptoms for several weeks in some cases. Steroids reduce inflammation. It is not a cure, as symptoms tend to gradually return. However, many people welcome the relief that a steroid injection can bring.
An operation is sometimes considered if other treatments do not help. Techniques that are used include:
· Manipulation. This is a procedure where the shoulder is moved around by the surgeon while you are under anaesthetic.
· Arthroscopic capsular release. This is a relatively small operation done as ‘keyhole’ surgery. It is often done as a day-case procedure. In this procedure the tight capsule of the joint is released with a special probe.
Although surgery has a good rate of success it does not help in all cases.
NEED A LOCAL OSTEOPATH?
If you live in Essex you can always visit our Chelmsford or Kelvedon ClinicsIf you have any queries about whether osteopathy can help your frozen shoulder please contact at on
In : Common Conditions
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