What is it?

Also known as Adhesive Capsulitis, it is an extremely painful and debilitating condition affecting the shoulder capsule, the connective tissue surrounding the shoulder joint. The joint capsule becomes inflamed and stiff with sticky adhesions which make any movement of the shoulder painful and restricted.

It is more common in women and those aged between 40 and 60 years old, but can also affect anyone for no reason at all. Having diabetes, thyroid problems and heart disease are all risk factor as is any problem which limits the use of your arm, such as a stroke or even a rotator cuff problem in the shoulder. Occasionally it can creep up weeks or months after a minor injury such as a simple fall or trip.

Reproduced with permission from www.shoulderdoc.co.uk

It typically develops in three stages:

1. Freezing phase (6 weeks to 9 months). This is the painful stage, with gradual loss of movement and often night pain.
2. Frozen phase (4 to 12 months). The pain begins to slowly settle but the stiffness really sets in and movement becomes increasingly restricted.
3. Thawing phase (12 to 42 months). Movement slowly return back to normal.

Normal Shoulder Capsule:

 

 

 

 

Frozen Shoulder Capsule:

Are any tests required?

Frozen shoulder is a clinical diagnosis and shouldn’t require any imaging or blood tests. Further scans such as x-rays and ultrasound scans may be done in order to rule out other problems and help clarify if the diagnosis is in doubt. Sometimes blood tests to check on causes of a frozen shoulder might be advised, such as a diabetes or thyroid test.

Treatment

Most frozen shoulders improve by themselves within 2 to 4 years after starting. However, most are so debilitating that they need treatment to ease pain and increase movement. There are several treatment options depending on the severity of stiffness and pain. These include:

  1. Simple pain killers, anti-inflammatories and watchful waiting
  2. Physiotherapy – can help limit further stiffness and increase range of movement
  3. Cortisone (steroid) injections (hyperlink steroid injections) into the shoulder joint- can reduce inflammation and help with pain but typically don’t last very long
  4. Hydrodistension – very effective at reducing pain and increasing range of movement, can be done in a clinic and does not require a general anaesthetic
  5. Surgery- this involves Manipulation Under Anaesthesic (MUA) or arthroscopic capsular release with excellent success rates
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