FROZEN SHOULDER

 

Frozen shoulder occurs when the lining of the shoulder joint (the capsule) becomes inflamed and thickened; this leads to marked pain and stiffness of the shoulder. The cause is unknown and it usually occurs completely spontaneously. However, it may occur after a minor injury or after surgery. It is particularly common in diabetics and may occur in the other shoulder at a later date.

The pain of frozen shoulder is often felt more in the upper arm than the shoulder itself. Patients often say that moving the arm suddenly by accident (for example reaching out quickly to catch something falling) can bring on extremely severe pain that may "bring you to your knees!"


Amazingly enough, a frozen shoulder resolves completely in almost all cases. However it does take a very long time – with the pain lasting 6-8 months and the stiffness improving over 2 years! Although the total recovery is prolonged people generally feel much better when the pain disappears.

 

 There are a number of important points to consider:-

1. There is no known cure. Many patients simply need to wait until the shoulder improves by itself.

2. It can be a very distressing condition particularly in view of the pain which is often felt most severely at night. You will probably need to see your GP to be prescribed pain-killing medications. Anti-inflammatory medications can be particularly helpful.

3. Most importantly, you must try to avoid stretching the shoulder- it will make it worse! This means you must not have any stretching physiotherapy and you should avoid stretching the shoulder in your day-to-day life. Try and use the shoulder only in the comfortable range of motion.

4. Injections of steroid into the shoulder can be very beneficial - they will not generally improve the range of motion but will often relieve some of your pain. You usually require two injections initially. A second course of injections can be done at 1-2 months if you wish.

7. Be very careful about information you may read on the internet - most of it is out-of-date or simply wrong!!!

 

Surgery can help in two situations

1. In the first 6-8 months the pain can be sometimes be severe. Arthroscopic (keyhole) surgery can then be used. It will NOT relieve all your pain and it will NOT improve your range of movement but it can remove enough of the pain to make a significant difference.

2. After the pain has gone (after 6 - 8 months) your shoulder will still be stiff. You can choose to wait the 12 months for the movement to return or, if you wish, arthroscopic surgery can return the movement immediately.

 

In summary, most people choose to wait for the condition to improve naturally. I am happy to see you back in my rooms if you would like to have another injection or if you wish to consider surgery - to relieve some of the pain in the painful stage (first 6-8 months) or to regain movement after the pain has settled (usually after 6-8 months).