Frozen Shoulder

What is frozen shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain and stiffness in your shoulder joint. It occurs when the capsule surrounding your shoulder joint becomes inflamed and thickens, leading to a decrease in the space available for movement. This results in a "freezing" of the shoulder, making it difficult and painful to move.

At Blacktown Health, our team of Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktown often see patients with frozen shoulder. We understand just how painful and worrying this condition can be, so we’ve put together this guide so you can better understand this condition and the treatments you can do to get it better.

‍

‍

What are the symptoms of frozen shoulder?

Frozen shoulder typically develops slowly and progresses through three stages, each with its own set of symptoms:

• Freezing stage:
  • Gradual onset of shoulder pain
  • Pain that worsens at night
  • Increasing difficulty moving your shoulder
• Frozen stage:
  • Pain may begin to decrease
  • Shoulder becomes very stiff
  • Range of motion is significantly limited
• Thawing stage:
  • Shoulder motion slowly improves
  • Pain may still occur with certain movements

‍

‍

What causes frozen shoulder?

The exact cause of frozen shoulder isn't fully understood, but several factors can increase your risk:

• Age and gender: It's most common in people between 40 and 60 years old, and women are more likely to develop it than men.
• Immobility: Prolonged shoulder immobility due to injury, surgery, or illness can lead to frozen shoulder.
• Certain medical conditions: Diabetes, thyroid disorders, and cardiovascular disease are associated with an increased risk.
• Previous shoulder injuries or surgeries: These can sometimes lead to the development of frozen shoulder.
• Hormonal changes: Some studies suggest a link between hormonal imbalances and frozen shoulder.

‍

How is frozen shoulder diagnosed?

When you visit one of the Tangram Health clinics with symptoms of frozen shoulder, our healthcare professionals will use several methods to diagnose your condition:

• Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
• Physical examination: Your Physiotherapist or Chiropractor will check your shoulder's range of motion, both when you move it yourself (active range of motion) and when they move it for you (passive range of motion).
• Pain assessment: They'll ask about the location and intensity of your pain.
• Imaging tests: In some cases, X-rays, ultrasound, or MRI scans may be recommended to rule out other conditions.

‍

What role does imaging play in diagnosing frozen shoulder?

While frozen shoulder is primarily diagnosed through physical examination, imaging tests can be helpful in some cases:

• X-rays: These can't show soft tissue changes associated with frozen shoulder, but they can rule out other conditions like arthritis or bone spurs.
• Ultrasound: This can show inflammation in the shoulder capsule and can be used to guide injections if needed.
• MRI (Magnetic Resonance Imaging): This gives a detailed view of the soft tissues and can show thickening of the shoulder capsule characteristic of frozen shoulder.

At Blacktown Health, our Physiotherapists and Chiropractors in Blacktown can refer you for these scans if necessary and properly explain what the results mean for your condition and treatment.

‍

‍

How is frozen shoulder treated?

Treatment for frozen shoulder aims to reduce pain and improve shoulder mobility. These include:

• Exercise therapy: Our Physiotherapists, Chiropractors, and Exercise Physiologists can teach you exercises to improve your shoulder's range of motion and strength.
• Pain management: Over-the-counter pain relievers or prescription medications may be recommended to manage pain and inflammation.
• Heat or cold therapy: Applying heat or cold to your shoulder can help manage pain and improve flexibility.
• Manual therapy: Techniques like joint mobilisation and soft tissue massage can help improve shoulder mobility.
• Corticosteroid injections: These can provide significant pain relief in some cases.
• Hydrodilatation: A procedure where sterile fluid is injected into the shoulder joint to stretch the capsule.
• Surgery: In severe cases or when other treatments haven't helped, surgery might be necessary.

‍

‍

When are injections used for frozen shoulder?

Injections, particularly corticosteroid injections, are often used in the early stages of frozen shoulder to reduce pain and inflammation. They can provide significant relief and may help you progress more comfortably with your physical therapy.

At Blacktown Health, our Physios and Chiros can discuss whether injections might be appropriate for your condition and can recommend these to your GP or local imaging centre to perform if needed.

‍

‍

When is surgery required for frozen shoulder?

Surgery for frozen shoulder is generally only considered when:

• Conservative treatments haven't improved your symptoms after 6 to 12 months
• You have severe, persistent pain and stiffness
• Your symptoms are significantly affecting your daily life or work

The most common surgical procedures for frozen shoulder are:

• Manipulation under anaesthesia: Where your shoulder is forcefully moved to break up adhesions while you're unconscious.
• Arthroscopic capsular release: A minimally invasive procedure to cut through the tight portions of the joint capsule.

If surgery is being considered, our Physios and Chiros in Blacktown can help you understand the procedure, recommend some good orthopaedic surgeons to perform it, and guide you through the post-surgical rehabilitation process afterwards.

‍

What role does exercise play in treating frozen shoulder?

Exercise is a crucial part of treating frozen shoulder. It helps to:

• Improve your shoulder's range of motion
• Strengthen the muscles around your shoulder
• Reduce pain and stiffness
• Prevent the shoulder from "freezing" further

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Blacktown Health can design an exercise program tailored to your specific needs and stage of frozen shoulder. This might include:

• Pendulum exercises: Gentle swinging motions to improve mobility
• Stretching exercises: To improve flexibility of the shoulder capsule
• Strengthening exercises: To build up the muscles that support your shoulder
• Posture exercises: To ensure you're not compensating in ways that could worsen your condition

Remember, it's important to follow your exercise program consistently but gently.

‍

‍

How can early intervention help with frozen shoulder?

Early intervention is key in managing frozen shoulder. Here's why:

• It can reduce the severity of the condition: Early treatment can help prevent the shoulder from becoming as stiff and painful as it might otherwise.
• It can shorten the duration: While frozen shoulder can last for 1-3 years if left untreated, early intervention can significantly reduce this timeframe.
• It can improve treatment outcomes: Starting treatment early often leads to better overall results.
• It can prevent complications: Early treatment can help prevent issues like muscle atrophy or compensatory problems in other parts of your body.

‍

Can frozen shoulder be prevented?

While not all cases of frozen shoulder can be prevented, there are steps you can take to reduce your risk:

• Stay active: Regular shoulder exercises can help maintain flexibility and strength.
• Manage underlying health conditions: If you have diabetes or thyroid disorders, keeping them well-controlled can reduce your risk.
• Proper posture: Maintaining good posture can help prevent shoulder problems.
• Early mobilisation after injury: If you've had a shoulder injury, follow your healthcare provider's advice on when and how to start moving your shoulder again.
• Stretching: Regular stretching can help maintain shoulder flexibility.

‍

When should I see a healthcare professional about shoulder pain?

You should consider seeing a healthcare professional if:

• You have persistent shoulder pain or stiffness lasting more than a few weeks
• Your shoulder pain or stiffness is affecting your sleep or daily activities
• You're unable to move your shoulder normally
• You've experienced a sudden injury to your shoulder

‍

Can frozen shoulder come back after it's healed?

While it's uncommon, frozen shoulder can recur. It's more likely to happen in the opposite shoulder than in the same one. However, if you maintain good shoulder health through regular exercise and proper posture, you can reduce the risk of recurrence.

‍

Take home message

Frozen shoulder is a challenging condition that can significantly impact your quality of life. However, with proper diagnosis, early intervention, and appropriate treatment, most people with frozen shoulder can regain their shoulder mobility and reduce their pain.

At Blacktown Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktowncan help you manage your frozen shoulder effectively. We offer a range of treatments and can provide personalised advice on exercises, lifestyle modifications, and pain management strategies. Remember, early intervention is key in managing frozen shoulder.

If you're experiencing persistent shoulder pain or stiffness, don't hesitate to contact us at Blacktown Health. We have clinics conveniently located across Sydney in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown, so you can get the right advice and treatment for your frozen shoulder.