Frozen Shoulder

What is a ‘Frozen Shoulder’?

Frozen shoulder syndrome, or ‘Adhesive Capsulitis’ is not a description of the shoulder temperature but is a very painful and debilitating condition characterized by severe pain and a general stiffness that affects movement of the shoulder in every direction.
There are 2 types primary, which starts for no known reason, and secondary following a trauma or surgery (particularly of the shoulder or following breast re-construction.)The reasons why it occurs are not well understood, but it is known that if you suffer with diabetes or Dupuytrens contracture you are more likely to suffer with a frozen shoulder. It is more common in women than men (60:40) and tends to affect those aged between 40-70 years of age. It is also thought that there may be hormonal, postural, autoimmune and genetic influences. Unfortunately once you have a frozen shoulder it will usually last for a long time, the average duration lasting for 30 months although corrective treatment can significantly reduce this time. There are 4 phases associated with a frozen shoulder.

Pre-Freezing (0-1 week)

Freezing –pain and progressive stiffening (1 – 8 months)

Frozen – very stiff and painful (9 – 16 months)

Thawing – gradual loosening (12 – 40 months)

Fortunately it is very rare to suffer with more than 1 frozen shoulder on the same side although in about 15-20% of sufferers it will affect the other shoulder. There are many painful and debilitating shoulder conditions and it is not unusual for people to be given an incorrect diagnosis of frozen shoulder (or self-diagnose incorrectly).

Why does the shoulder become frozen?

The main ball and socket part of the shoulder joint is surrounded by lax elastic capsule. This capsule can become inflamed and sticky, forming adhesions that effectively glue the capsule together and cause it to temporarily lose its elastic nature and become fibrotic (similar to an elastic band that becomes hard and loses its stretch). The inflammation may then spread into other shoulder soft-tissues potentially causing swelling in fluid filled sacks (bursae) of the shoulder and shortening and stiffness of the muscles.

The stiffness is believed to be due to an overreaction of the body to the inflammation. The body then seems to ‘switch off’ muscles so that they are unable to work properly and gradually become stiff and painful. In less than a week the arm movements start to reduce, and within a few weeks the arm literally becomes frozen and many sufferers are unable to raise their arm more than 40° in any direction. The muscles of the rotator cuff become weak and start slowly to waste away, leaving the arm to hang stiff and immobile.

Can it be treated?

Traditionally a frozen shoulder would be treated with anti-inflammatory tablets, steroid injections and various forms of physical therapy. These are not always effective and may have unpleasant and unwanted side effects.

Our methods of treatment are aimed at reducing inflammation to assist in releasing the stiffness of the capsule and reduce the pain in the surrounding soft tissues. It is also essential to re-programme the muscles and nervous system allowing for improved function and mobility.

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