Frozen shoulder

Introduction

Adhesive Capsulitis or ‘Frozen Shoulder’ as it is more commonly known is a debilitating condition characterised by persistent pain and severe restriction of all movement, both actively and passively in the shoulder joint.

Adhesive Capsulitis can occur spontaneously but it is usually associated with one of the following risk factors; trauma to the shoulder or arm, chronic conditions such as diabetes or hypothyroidism, being female or over 40.

It is often confused with other shoulder conditions such as subacromial impingement, which can mimic the pain and restriction in movement of adhesive capsulitis.  Despite its frequent diagnosis, adhesive capsulitis is uncommon, occurring in just 3% of the population.

Symptoms

Early signs of adhesive capsulitis include discomfort when moving the shoulder close to its end range. Pain may also be felt on certain combinations of movement such as abduction and external rotation (like reaching for a seatbelt) or extension and internal rotation (taking something out of a back pocket). As symptoms progress the shoulder becomes painful at night and at rest. The pain is often constant and it can be difficult to find relief.

Once the process has begun it can be very difficult to reverse. Adhesive Capsulitis is broken up into three phases; Freezing, Frozen and Thawing. Each phase can be distinguished by certain characteristics.

1) Freezing

Classic symptoms in this phase would include progressively worsening and persistent pain in the shoulder. Range of movement in the shoulder becomes restricted and starts to impact simple day to day activities.

2) Frozen

The frozen period shows reduction of pain but the restricted mobility remains.

3) Thawing

Mobility starts to return and normal function can be re-established. Manual therapy and rehab can be beneficial at this time to ensure normal range is restored.

Summary

Adhesive Capsulitis is a self limiting condition and will gradually improve with time.  Hands on treatment from an Osteopath, Physiotherapist or Sports Therapist may aid pain relief and minimise secondary compensation in the neck, upper back and arm.

How can we help?

If you have this problem or any other problem related to frozen shoulder then contact us today to get advice.

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References

Dias R, Cutts S, Massoud S. Frozen shoulder. BMJ : British Medical Journal. 2005;331(7530):1453-1456.

Rangan A, Goodchild L, Gibson J, et al. Frozen Shoulder. Shoulder … Elbow. 2015;7(4):299-307. doi:10.1177/1758573215601779.

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