What is frozen shoulder?
Frozen shoulder, also known as ‘adhesive capsulitis’, is a condition in which the shoulder joint becomes initially painful and then progressively stiff with restricted range of movement. The onset is often insidious, so you may not have noticed any particular injury or event that caused your symptoms. There is a gradual reduction in both active and passive range of movement – you may notice difficulty with overhead activities, dressing and getting your hand behind your back.
Frozen shoulder progresses through three phases which tend to overlap:
Acute/freezing phase – this phase can last anywhere from 3-9 months. Symptoms start with shoulder pain at rest and at night.
Adhesive/frozen phase – this phase can occur from about 4 months and last up until 12 months. Pain starts to reduce, and range of movement becomes more restricted. You may only notice pain at end ranges of movement.
Resolution/thawing phase – spontaneous improvement in symptoms and range of movement. This phase can last anywhere between 1-3 years.
What causes frozen shoulder?
The cause of frozen shoulder remains unclear and is most likely multi-factorial. Frozen shoulder can be either primary or secondary.
It is considered primary if the condition has come on spontaneously, with no known cause or trauma. Frozen shoulder can occur secondary to trauma, surgery or other pathology. Risk factors for secondary frozen shoulder can be systemic conditions such as diabetes, and shoulder pathologies such as rotator cuff tendinopathy. Frozen shoulder is more prevalent in women and those aged 40-65.
How can physiotherapy help?
At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm the diagnosis, help you manage pain and return to normal activity.
Treatments which can help frozen shoulder include:
- Home exercises – your physiotherapist will go through an exercise programme with you which may include gentle range of movement exercises to maintain and improve joint mobility. The exercises prescribed and how much you can do will depend on the stage of the condition.
- Soft tissue massage – this can help to reduce any muscular tension which may develop as a result of the condition.
- Shockwave therapy – this has been shown to provide some benefits for frozen shoulder. See our page on ‘shockwave therapy’ for more information on this.
- Corticosteroid injection – this can be used in the early stages of the condition to help reduce inflammation and manage pain.
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