by Alan Jordan
Frozen shoulder is a common condition, which may develop following an injury but it may also appear with no warning or trauma.
The term Adhesive Capsulitis describes the characteristic adhesions and contracture of the fibrous capsule that surrounds the shoulder. The cause of this condition is still not clear although it has been linked to other medical problems such as diabetes, thyroid problems and history of heart attack.
Anatomy
The shoulder is made up of 3 bones: the shoulder blade (scapula), collar bone (clavicle) and the upper arm (humerus). The shoulder capsule is a sack-like structure formed of connective tissue and ligaments. It is filled with fluid which offers lubrication to this highly mobile joint.
The three phases of a frozen shoulder:
‘Freezing’ phase – gradual increase in pain and loss of shoulder movement. Movements like fastening the bra strap or shaving become problematic. Sleeping on the affected side is usually quite uncomfortable.
‘Frozen’ phase – Continued restriction may last up to a year and this is where most sufferers seek help.
‘Thawing’ phase may last between 5 months to 2 years. During this phase the range of movement is gradually restored.
Management
Pain relieving medication and ice therapy are usually beneficial in conjunction with physiotherapy. As the pain levels are managed, passive mobilisation of the articulation is much more tolerable. In the meantime, the patient should adhere to an exercise program of daily self-mobilisation and stretching. A corticosteroid injection may also be discussed to achieve a therapeutic window where more ‘aggressive’ shoulder mobilisation could be done to restore full range of motion.
Should this not achieve the desired effect, Manipulation under Anasthesia (MUA) performed by an orthopaedic consultant may be appropriate. If everything else fails, surgery in the form of an arthroscopy is performed to release the adhesions.
The team at the Broadgate Spine & Joint Clinic is indeed broad and can provide all diagnostic and treatments related to frozen shoulder and all other shoulder related conditions.
