A frozen shoulder is characterised by stiffness and pain in the shoulder joint. For some people, pain is commonly worse at night, often disturbing sleep patterns.

 

Inside your shoulder joint, all the bones, ligaments and tendons are surrounded by connective tissue. Frozen shoulder happens when this connective tissue thickens and tightens around the joint, thus restricting movement.

Unlike a rotator cuff tear, it is still unclear why a frozen shoulder occurs. It has been found that it commonly happens in diabetics or those that have immobilised their shoulder due to an underlying mild to moderate shoulder injury. Frozen shoulders have also been linked to medical conditions such as a stroke, heart disease, thyroid disease and Parkinson’s disease.

 

The 3 stages of a frozen shoulder

Freezing stage:

This stage is where you start to develop pain when you move your shoulder. It gradually gets worse over time and your shoulder movements start to become restricted.

Frozen stage:

In this stage your pain may improve, but the movement of your shoulder becomes more restricted, often making daily activities very challenging.

Thawing stage:

This is where your movement starts to return to normal.

Your doctor or physiotherapist can diagnose you following a physical shoulder assessment. Occasionally you may be required to have an x-ray, ultrasound or MRI to rule out any other problems that may be occurring simultaneously.

Treatment of a frozen shoulder

  • Steroid injection. If your frozen shoulder has been diagnosed within a month of it first occurring, it has been shown that steroid injections are effective in reducing pain and improving movement. Anything over a month reduces the effect of the steroid injection and some doctors will not give you a steroid injection at this point.
  • Anti-inflammatory medication. Talk to your GP about a prescription for an anti-inflammatory. It is best to take these at night as this is when the pain is usually at its worst.
  • Physiotherapy. Your physiotherapist will show you exercises to do to maximise your movement but minimise your pain. Hydrotherapy is a great way to help with this. Your physiotherapist will gradually try to improve your shoulder movement while respecting the pain.
  • Hydro dilation. This is sometimes effective to assist with improving the movement in your shoulder. The doctor will inject sterile saline into the joint to help stretch the joint capsule and assist with joint distention.
  • Surgery. This is very rarely necessary to treat a frozen shoulder. This is done arthroscopically (key hole surgery) and is a last resort.

For more information or to book an appointment please call  031 563 1314 or email physio@carolinehawkins.com

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