Frozen Shoulder

Known medically as adhesive capsulitis, frozen shoulder is a very common and often extremely painful condition which causes the shoulder to stiffen and become completely or partially immobile.

Patients often comment that there was no noticeable trigger event. Initially, they report pain in the shoulder, increasing with movement and often worsening at night, affecting their ability to sleep.

This typically lasts up to nine months and is then followed by growing stiffness – this can result in up to 50 per cent less mobility in the affected arm. Often, there is then an easing in the pain and lack of mobility, however, that can take more than two years.

For more information on frozen shoulder and your possible treatment options, call +44 (0) 203 195 2442 to arrange a consultation with the London Shoulder Specialists.

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What are the causes of frozen shoulder?

Frozen shoulder can be triggered by even a mild injury or trauma to the shoulder, but it is also associated with underlying health concerns such as high cholesterol, diabetes, heart disease, Parkinson’s, hyperthyroidism and hypothyroidism and a hand condition called Dupuytrens contracture.

The lining of the shoulder joint, known as the shoulder capsule, is lubricated with synovial fluid to facilitate the shoulder’s wide range of motion, but in frozen shoulder there is insufficient synovial fluid and the lining becomes inflamed, swollen and begins to contract, restricting movement.

During your consultation at the London Shoulder Specialists, your symptoms will be discussed in full and your range of movement and degree of pain is assessed. Typically, we will then conduct investigative tests such as X-rays and MRIs to check the amount of inflammation and whether osteoarthritis or soft tissue damage is also a factor.

What are my treatment options for frozen shoulder?

For most patients, frozen shoulder will eventually resolve itself, but this can take approximately two to four years from the initial onset of pain. During this period, the pain and lack of mobility can be debilitating, so many seek treatment.

Treatment options include physiotherapy, painkillers and anti-inflammatories and steroid injections that can reduce the inflammation, to control the pain and increase mobility. Another option is the hydrodilation procedure which is an injection that stretches the shoulder capsule.

Surgery is also an option; either an arthroscopic capsular release or manipulation of the shoulder joint. Either procedure should be followed with physiotherapy for optimal success.

For more information on frozen shoulder and your possible treatment options, please get in touch to arrange a consultation.

Frequently Asked Questions on Frozen Shoulder

A frozen shoulder is often misdiagnosed as a rotator cuff tear as the symptoms are very similar. However, patients that have experienced a rotator cuff injury can usually lift their shoulders manually. There may be pain on movement but there is no marked stiffness. In contrast, the limited range of motion associated with a frozen shoulder can make it challenging to raise your arm past a certain point.

Frozen shoulder is also often confused with shoulder bursitis because both cause similar pain at night and reduced shoulder mobility.

Frozen shoulder can initially be very painful. Over time it can become increasingly stiff, making it difficult to move the affected shoulder. The pain is worse at night, which can cause insomnia.

The specific causes of frozen shoulder are unknown, but secondary adhesive capsulitis develops from a known cause. It typically follows a shoulder injury, surgery, or a prolonged period of immobilisation. A primary frozen shoulder is more common in women aged 40 – 60 years and may have a hormonal relationship. It is also more common in diabetic patients.

Frozen shoulder can get better without any intervention. However, recovery can be prolonged, taking at least 18 to 24 months, and in some cases, many years. Some patients fail ever to recover full mobility.

Although they are typically infrequent, there can be complications after frozen shoulder surgery. These include infection, nerve injury, dislocation, and recurrence of shoulder stiffness.