Frozen shoulder can present with symptoms such as decreased flexibility and stiffness in the shoulder along with pain when reaching out with the shoulder. Over the course of time, the shoulder ends up becoming very hard to move. The condition only occurs in around 2 percent of the population. Most of the time, it affects individuals who are between 40 and 60 years of age. It occurs more often in women than it does in men.
The most common time to get frozen shoulder is following shoulder surgery, especially rotator cuff repair
and shoulder decompression. This is probably due to the extent of arthritis in the shoulder that needed to
be “cleaned-out”, which causes trauma to the shoulder. The resultant pain prevents mobility in the
shoulder which then leads to stiffness. The stiffness gets worse and within two weeks the shoulder can be
The age range usually varies from 40-60 years of age, especially those with certain medical conditions such as diabetes. Other issues after surgery involve the use of a sling to protect the rotator cuff. A lack of mobility to the
shoulder leaves the shoulder joint at risk of developing frozen shoulder (sometimes known as secondary
The pain arises from when the joint capsule/ligaments become inflamed and thickens which then causes joint restriction.
The stages of Frozen Shoulder:
- Inflammation of joint capsule causes it to swell and thicken and develop scar tissue and adhesion’s.
- The reduced space in the joint cavity now causes the Humerus (Arm) to rotate in its socket creating more pain and stiffness.
- The lubricating synovial fluid in the shoulder joint is decreased.
The 3 main stages:
- Pain, decreased shoulder motion (Freezing).
- Decrease pain, mainly stiffness (Frozen).
- motion in the shoulder and strength are normal or partially (Thawing).
Not everyone needs surgery, there are other non-surgical treatments including injections and physical therapy.
How to Treat Frozen Shoulder:
- Anti-Inflammatory Medication
Ibuprofen and aspirin can help to reduce swelling and pain. As the swelling decreases, the
amount of pain that accompanies it will diminish as well. However many therapists discourage
the use of anti-inflammatories because frozen shoulder takes a long time to resolve (often many
months) and using anti-inflammatories for more than 2 weeks is not recommended.
- Steroid Injections
Cortisone is a powerful form of an anti-inflammatory medication that can be injected directly into
the shoulder joint. It can give patients a step-forwards but very rarely cures a frozen shoulder.
- High Volume Injection
Sometimes called hydrodilatation, a high volume of saline and steroid are injected into the
shoulder capsule with the intension of stretch the capsule from the tight adhesions. The
procedure takes about 15 minutes and is usually done under X-ray or ultrasound. Results vary but
most people (around 70%) report some benefit from the injection.
Performing specific exercises can help to restore motion. This can be under the direct
supervision of a trained Osteopath or performing them in the comfort of your own home. Therapy
entails stretching and range of motion exercises for the shoulder joint. Osteopathy will also include some hands-on treatment consisting of a range of techniques. You can use a heat source
or hot water bottle for loosening the shoulder before engaging in any stretching exercises.
Some therapists might also use other modalities including acupuncture, electrotherapy, ice and heat
treatment and ultrasound.
If your symptoms aren’t alleviated with therapy and using anti-inflammatory medication, you and
your doctor can discuss surgery as an option. The most commonly used procedure is called an
MUA (manipulation under anaesthesia). Essentially you will be under general anesthetic and the
surgeon will move your arm firmly above your head and rotate your arm. Pops and clicks will
come from the shoulder joint which mobilises the scar tissue. If the scar tissue is too thick, a
capsular release may need to be performed where the capsule and scar tissue is cut by an electrical knife (during a keyhole procedure). The arm is mobilized at the same time to ensure full
range of movement occurs.
More serious shoulder problems may require decompression surgery. It is important that you
discuss the potential for recovery using simple treatments, as well as the risks associated with
surgery. The goal of surgery for the condition is to stretch and release the joint capsule that is
• Frozen shoulder tends to occur more often in those who have diabetes, affecting around 10 to 20
percent of individuals. The reason isn’t known at this time.
• Frozen shoulder often develops following a shoulder surgery that has left the joint immobilized
due to the surgery, fracture or other type of injury.
• Moving your shoulder soon after your surgery is one of the best methods for preventing frozen
• Pain is often aching or dull. During the early part of the disease, the pain tends to be worse when
you are able to move your arm. It is located over the outer part of the shoulder and into the
• Follow the exercise rehab plan from your therapist. Failure to do regular exercises will
significantly slow your recovery.
Feel free to call us at:
Hazel Grove Osteopathic Surgery on 0161 483 6986 for appointments on Wednesday, Friday and Saturday. 302 London road, Hazel Grove, SK7 4RF.
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