Unfreezing the Frozen Shoulder
Shoulder stiffness and discomfort are common symptoms encountered in day-to-day life. Most of these symptoms are usually mild and improve quickly by themselves, but once in a while, there may be a stiff shoulder that may be more painful, or take longer to recover. You may have heard stories about friends or relatives who suffered from a condition called frozen shoulder, and wondered: what is a frozen shoulder, and more importantly, do I have it?
What is a frozen shoulder?
Frozen shoulder, or adhesive capsulitis in medical terms, is a condition where the shoulder becomes stiff and painful. The stiffness can be severe enough that it becomes difficult to even lift or move the arm, hence the name frozen shoulder. With time, the condition can improve by itself, although the recovery process may take upwards of up to 2 to 3 years.
Although the presentation and progression of the condition is well understood, there is still a lot to learn about the exact cause. It is thought that the stiffness and pain is due to the tightening and the thickening of the connective tissues in the shoulder, leading to thick bands of stiff tissue called adhesions. These adhesions restrict the movement of the shoulder, and cause pain and discomfort in the shoulder.
Factors that increase the chance of developing frozen shoulder:
Gender: Women over 40 are more likely to develop frozen shoulder than men of the same are group.
Health conditions: Individuals with diabetes, or thyroid conditions.
Shoulder injury, or surgery: lack of movement after a shoulder injury or surgery
Signs and symptoms of as frozen shoulder
Shoulder pain and stiffness can be due to many causes, such as injury to the shoulder muscles, or even nerve pain from the neck. Luckily, there are a few signs and symptoms that help to differentiate frozen shoulder from other types of shoulder pain.
Stiffness: Although difficulty with movement is common in shoulder conditions, the stiffness in frozen shoulder is quite different from other shoulder conditions. When an individual has frozen shoulder, the limitation in shoulder flexibility is the same whether the individual moves the arm by themsleves , or is helped by another.
Presentation: Frozen shoulder has a typical presentation involving a few stages as the condition progresses that help to identify it apart form other shoulder conditions
Painful/ Freezing stage: This is the first stage characterised by the slow onset of stiffness and pain in the shoulder, with the pain being the more dominant feature. The pain can be present even without movement, and can be intense enough to affect sleep, and may require medication to help manage, if it is especially severe. This stage can last a few weeks to 6 to 9 months.
Sttiffness/ Frozen stage: In this stage, the pain improves and becomes much more manageable, but the shoulder become extremely stiff. It becomes difficult to lift the arm, or reach behind, This stage can last up to 9 months.
Thawing: During this stage, the shoulder gradually improves, and is usually not noticeable except when the shoulder is stretched to the end.
Management of a Frozen Shoulder
Physiotherapy management has been shown to be effective in reducing pain intensity, and reducing the recovery time of frozen shoulder. Although frozen shoulder can resolve on its own, physiotherapy can help the shoulder regain full function in a shorter duration.
Assessment and education: Your physiotherapist will conduct a thorough assessment to determine the cause of your shoulder pain. Once it has been been assessed that you have frozen shoulder, your physiotherapist will be able to advise you on the likely stage of the condition you are at, and your individual management plan.
Pain management: Gentle movement and mobilisation of the shoulder can help with relieving some of the pain symptoms. If the pain is very severe, your physiotherapist may refer you to a doctor for pain medications.
Shoulder flexibility: Regaining full shoulder flexibility can be difficult, and some individuals may experience lingering shoulder stiffness without treatment. A stretching program will be taught to you, and manual therapy to help loosen the shoulder joint and muscles will also be applied to help regain full shoulder mobility.
Strengthening: It is common to develop shoulder muscle weakness due to the reduced movements over months in frozen shoulder. This weakness can make i difficult to move the arm, and also make it easier to develop other type of shoulder pain. Your physiotherapist will help develop an appropriate strengthening program to restore your muscle strength and control during the recovery process.
Frozen shoulder can be a frustrating condition to manage, s the pain and stiffness make it difficult to manage daily activities. With proper consultation and treatment with your healthcare professional, most individuals can regain full flexibility and function or their shoulder. If you are looking for help to manage your frozen shoulder, feel free to contact our team of dedicated physiotherapists at info@prophysio.com.sg , call 6581 9688, or whatsapp 9752 9688.
