Frozen Shoulder or adhesive capsulitis is an inflammatory condition that is a common source of significant pain and stiffness. The connective tissue of the ball socket joint, known as the joint capsule, becomes swollen and inflamed which is what makes shoulder movements very stiff and sore.
People with auto-immune disorders such as diabetes/ rheumatoid arthritis and lupus are at greater risk developing frozen shoulder.
There are two main types of frozen shoulder: primary frozen shoulder that occurs spontaneously without any clear cause and secondary frozen shoulder that is caused by lack of use following injury or surgery. An in depth history and examination is vital in order to differentiate it from other sources of shoulder pain and stiffness. Frozen shoudler is considered a diagnosis by exculsion so plain Xrays of the shoulder should be taken to rule out the possibility of avascular necrosis of the femoral head.
Frozen shoulder can last anywhere for 6 months to 2 years depending on how it is managed and its severity. There are two distinct phases of frozen shoulder.
The first phase is known as the inflammatory phase that is characterised as more pain than stiffness. In this phase you will likely have frequent pain (even at rest) and difficulty sleeping. Your shoulder will gradually loose more and more range of movement while it “freezes”.
The second phase is known as “thawing” and is characterised by more stiffness than pain. In this phase the constant pain settles leaving global stiffness. As the shoulder transitions out of the inflammatory phase, it will gain more and more movement over time.
Physiotherapy for frozen shoulder consists of manual therapy, massage and/or dry needling to help loosen the soft tissues around the joint. Your physio will also give you a series of exercises to help stretch and strengthen your shoulder at home.
While it may be tempting to just “let it go”, quality physiotherapy can help prevent future shoulder conditions due to lack of use such as rotator cuff tendinitis, weakness from muscle atrophy and even neck and back pain.
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