Frozen Shoulder

Adhesive capsulitis, more commonly known as Frozen Shoulder is a condition whereby the affected individuals experience shoulder pain, followed by stiffness which spontaneously resolves.

Adhesive capsulitis, more commonly known as Frozen Shoulder, is a condition causing a painful and stiff shoulder. It is not known what causes frozen shoulder, it has a gradual onset with no clear mechanism or reason for the pathology. Typically, a frozen shoulder has three clear phases. It first presents as a painful shoulder, which progresses to a restricted shoulder range of motion before spontaneously resolving. Despite not knowing the cause of frozen shoulder, research shows that it most commonly presents between the ages of 40 to 60 years old and is more common in women. Those diagnosed with diabetes mellitus also have higher rates of frozen shoulder, with up to 10-20% being affected.

As mentioned, the majority of frozen shoulder cases follow three main phases throughout the course of the condition. In some cases these phases are less defined, with symptoms less specific and remaining throughout the condition.

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Phase 1 – Freezing:

The first phase of frozen shoulder is known as the freezing phase. The main symptom throughout this phase is shoulder pain. This can be noticed at rest, with certain shoulder movements, or particularly at the end of the available shoulder range of motion. Pain at night is extremely common in this phase and is often accompanied by difficulty lying on the affected side. The pain can start to limit what activities can be performed as excessive shoulder use could aggravate pain. Range of motion may start to become restricted towards the end of this phase as the condition progresses into phase two.

Phase 2 – Frozen:

The second phase is known as the frozen phase. Throughout this phase, pain decreases, which provides much-needed relief to individuals with frozen shoulder. However, as pain decreases shoulder range of motion is reduced, hence the name ‘Frozen Shoulder’. The extent to which the range of motion and stiffness is present varies between cases, with some having severely restricted movements and others still maintaining a functional amount of range. Functional movements of the shoulder are reduced, with the lack of range of motion making daily activities difficult. This phase can unfortunately last for months.

Phase 3 – Thawing:

The last phase of frozen shoulder is known as the thawing phase. This phase is where we see the resolution of the condition. Pain should already be fully resolved before this, and throughout this phase range of motion continues to improve. Recovery is spontaneous and timeframes for healing are also very varied. In many cases it can take up to two years for the resolution of frozen shoulder, however, unfortunately in some instances full range of motion may not return.

Although frozen shoulder is a progressive condition with spontaneous recovery it is valuable to see a 13th Beach Health professional to manage this condition and help provide relief of symptoms and maintain function. Following a home exercise program and getting hands-on treatment can help to reduce the loss of range of motion and assist recovery.

Depending on the phase of frozen shoulder the aims of treatment will vary. Initially, in phase one the main aim will be to provide pain relief. This can be achieved through multiple avenues. Health professionals such as physiotherapists or osteopaths can provide hands-on treatment to release muscles around the shoulder joint and promote pain-free movement. The use of prescriptions for pain relief or anti-inflammatories from doctors may be required for relief. Hydrodilation may also be considered in severe cases of frozen shoulder when other avenues have been exhausted. This involves a cortisone and saline injection into the shoulder capsule which aims to reduce inflammation and allow for more movement.

The main aim of the second and third phases of frozen shoulder is to prevent loss of range of motion and to increase range of motion throughout the resolution of the condition. This can be assisted through the use of hands-on treatment and through range of motion exercises prescribed by a physiotherapist. The majority of exercises prescribed for frozen shoulder can be performed at home with minimal equipment. This makes the rehabilitation process accessible to all and allows for flexibility of incorporating it into your daily routine.

Once range is regained and pain is reduced there is the temptation to ease off from home exercise programs. However, after having months to years of impaired shoulder function, strength deficits can be present. It is therefore really important to follow a strengthening program to ensure optimal shoulder function and to avoid injury. Having a professional, such as our physiotherapists near Warralily, guide you through the exercise rehabilitation is the best way to ensure great results for you and your shoulder.

Although the longevity and unknown causes of frozen shoulder can at times be disheartening there are plenty of ways health professionals can support you throughout the condition and into recovery. There are many ways to help manage pain, and reduce the impairments from frozen shoulder to give you the best outcomes. Contact our physiotherapists in Charlemont area for more info.