Frozen shoulder guide

Frozen Shoulder: A Detailed Overview

Frozen shoulder, also known as adhesive capsulitis, is a debilitating condition that significantly affects shoulder mobility and causes persistent pain. In this detailed overview, we will explore the various aspects of frozen shoulder, including its definition, causes, symptoms, diagnosis, treatment options, and the potential for recovery without surgery.

What is frozen shoulder?

Frozen shoulder is a condition characterised by the gradual onset of pain and stiffness in the shoulder joint, leading to limited range of motion. It primarily affects the capsule surrounding the shoulder joint, causing it to thicken and contract. This results in the formation of adhesions, restricting the movement of the shoulder.

What are the main causes of frozen shoulder?

The exact cause of frozen shoulder is not always clear, and patients often don’t recall an initial triggering event, but several factors may contribute to its development:

  • Inflammation: Inflammation of the shoulder capsule can lead to the thickening of the synovial lining, restricting movement.
  • Immobilisation: Prolonged immobilisation of the shoulder, such as after surgery or injury, increases the risk of developing frozen shoulder.
  • Underlying medical condition: Certain medical conditions, including diabetes, cardiovascular disease, high cholesterol, Parkinson’s and thyroid disorders, have been associated with an increased risk of frozen shoulder. Also, a hand condition called Dupuytren’s contracture.
  • Hormonal association: Women aged between 40 and 60 years old are more prone to developing frozen shoulder.
  • Previous shoulder conditions: Individuals with a history of shoulder injuries or surgeries may be more susceptible to developing frozen shoulder.

Unlike frozen shoulder, secondary adhesive capsulitis develops from a known cause, typically following a shoulder injury, surgery, or a prolonged period of immobilisation.

What are the symptoms of frozen shoulder?

The symptoms of frozen shoulder often develop gradually and progress through stages. The main symptoms are persistent pain in the shoulder that worsens with movement as well as shoulder weakness and a gradual loss of range of motion, making it difficult to perform daily activities.

Pain and discomfort may interfere with sleep, particularly when lying on the affected side. Sometimes it can be mistaken for bursitis as this also causes pain at night.

A frozen shoulder is often misdiagnosed as a rotator cuff tear as the symptoms are very similar. However, unlike frozen shoulder, with a rotator cuff tear, there is no marked stiffness or limitation in range of motion when raising the shoulders.

How is frozen shoulder diagnosed?

Frozen shoulder can be diagnosed by your London Shoulder Specialist based on your symptoms and medical history along with a thorough physical examination for checking your range of movement and assessing your degree of pain.

X-rays or MRI scans can be ordered to check the amount of inflammation and whether osteoarthritis or soft tissue damage is also a factor.

Can frozen shoulder get better without surgery?

Often, cases of frozen shoulder can improve with conservative, non-surgical treatments. However, this can take 18 to 24 months to heal by itself, and sometimes much longer – with patients sometimes failing to regain full mobility. Application of heat or ice packs, and anti-inflammatory medication, or having steroid injections can provide relief from pain, improved mobility and reduced inflammation.

What surgical options are there for frozen shoulder?

While surgery is not always the first line of treatment, it may be considered if conservative measures prove ineffective. The surgery for frozen shoulder is Arthroscopic Capsular Release. A minimally invasive procedure where the surgeon releases the tight capsule using small incisions and an arthroscope.

Occasionally, Manipulation Under Anaesthesia (MUA) can be performed. This is a procedure where the patient is put under anaesthesia, and the surgeon manipulates the arm to break up adhesions and improve range of motion.

What is the recovery time after frozen shoulder surgery?

The recovery time after surgery for frozen shoulder varies depending on the type of procedure and individual factors. Physical therapy is typically a crucial component of rehabilitation, and patients may begin gentle exercises to regain strength and mobility soon after surgery. Full recovery may take several weeks to months.

Are there any complications from frozen shoulder surgery?

Complications from frozen shoulder surgery are rare but any surgical procedure carries a risk of infection, although this risk is minimised with proper surgical techniques and postoperative care.

In rare cases, nearby nerves or blood vessels may be affected during surgery. Despite surgery, some individuals may experience a recurrence of shoulder stiffness and symptoms.

Can frozen shoulder be prevented?

While it may not be entirely preventable, you can lower the risk of frozen shoulder. Managing conditions such as diabetes and cardiovascular disease can help reduce the risk of frozen shoulder, but also doing regular shoulder exercises can help to develop strength and flexibility here. It is crucial to seek a confirmed diagnosis as soon as you suspect a frozen shoulder to prevent the condition worsening.

Frozen shoulder is a challenging condition that can significantly impact daily life. Early intervention and a comprehensive approach to treatment are key factors in managing it successfully.

If you suspect frozen shoulder, seek a confirmed diagnosis and tailored treatment plan from your London Shoulder Specialist. To book an appointment, call +44 (0) 203 195 2442.