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Frozen Shoulder

frozen shoulder

The typical symptoms are pain, stiffness, and limitation in the range of movement of a shoulder. The symptoms typically have three phases:

  1. Phase one - the 'freezing', painful phase. 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.
  2. Phase two - the 'frozen', stiff (or adhesive) phase. 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.
  3. Phase three - the 'thawing', recovery phase. This typically lasts between one and three years. The pain and stiffness gradually go and movement gradually returns to normal, or near normal.

Who gets frozen shoulder?

It most commonly occurs in people aged between 40 and 65 years. 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. Either shoulder can be affected but most commonly it is the non-dominant shoulder - that is, the left shoulder in a right-handed person.

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.

Do I need any tests?

The diagnosis of frozen shoulder is usually made by a doctor's examination. You may also have an X-ray or an MRI scan of your shoulder joint.

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.

Ordinary painkillers

Paracetamol may be advised first to try to control the pain.

Anti-inflammatory painkillers

Examples anti-inflammatory painkillers include ibuprofen, diclofenac and naproxen. These drugs work by helping to ease pain and also by reducing any swelling (inflammation) in your shoulder.

Shoulder exercises

These are commonly advised. The aim is to keep the shoulder from 'stiffening up' and to keep movement as full as possible.

Physiotherapy

Many people are referred to a physiotherapist who can give expert advice on the best exercises to use. Also, they may try other pain-relieving techniques such as warm or cold temperature packs and transcutaneous electrical nerve stimulation (TENS) machines.

A steroid injection

An injection into, or near to, the shoulder joint brings good relief of symptoms for several weeks in some cases.

Surgery

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. In this procedure, the tight capsule of the joint is released with a special probe.

What is the outlook?

The symptoms of frozen shoulder can persist for 18 months to 3 years or more. However, the vast majority of people with a frozen shoulder do recover to normal levels of function and movement by two years, even without any treatment.


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