What Is Frozen Shoulder?!
Published: 17 August 2024
Frozen shoulder is a painful condition of the shoulder that results in stiffness and loss of movement. An often misdiagnosed condition, many people with frozen shoulder complain of high levels of pain and find the condition very debilitating.
It is also quite a poorly understood condition as a whole, and every year or two there is new evidence helping the medical field understand the processes and factors involved in frozen shoulder a little better.
So what thought we’d summarise what we know…
What Happens with Frozen Shoulder?
Firstly, the term “frozen shoulder” is a little outdated. In medical circles, a better description of the condition is an adhesive capsulitis or adhesed shoulder. After all, there is really no freezing of the shoulder…
It is an inflammatory condition of the joint’s capsule (a covering like structure that helps provide stability). There can be changes in the blood vessels of the tissue and fibrosis of the capsule (build up soft tissue that stiffens the capsule further). This can eventually lead to a reduction in the volume of the shoulder joint itself.
The combined processes, like we discussed can be very painful and debilitating resulting in lost work days, issues sleeping and an overall reduction in quality of life.
Diagnosis
Diagnosis is fairly straight forwards. Firstly, a physio or other clinician will look at the range of motion of the painful shoulder. External rotation (outwards turning of arm) is typically affected, and we normally see a general and fairly equal restriction of active movements (where you perform the movements) and passive movements (where the physio moves you).
We often want to arrange an x-ray of the shoulder to rule out arthritis and some other conditions that can restrict movement.
We might also look at person’s history. Frozen shoulder is more common in people around middle age, and may affect females more than males. Additionally, some conditions such as diabetes can increase the risk.
Treatment
Physiotherapy is often a first line treatment of frozen shoulder. Combined range of movement (gentle stretching) and strengthening are often used to try and maintain or improvement movement, while avoiding de-conditioning.
Often corticosteroid injections are used to manage frozen shoulders, particularly those that are very painful.
It must be mentioned though, that just how effective these treatments are is not yet fully understood, and is an area of research need.
If someone has higher levels of pain and restriction that is persistent, then there are surgical options such a manipulations under anaesthetic, and capsular releases (appears to be gold standard).
There is one other option, which is less discussed however. That is the “wait and see” method. Most frozen shoulders will get better in time with or without treatment, however this does appear to be over multiple years. The pain levels are often more severe earlier in condition, and slowly dissipate as time goes by. So, it might be reassuring to know the higher levels of pain do not last.
The Message
Although often fairly painful, frozen shoulders generally do get better with time. There are some treatments out there which may benefit some people with the condition.
But time does heal almost frozen shoulders.
Oh and nothing freezes.