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Frozen shoulder

Also known as adhesive capsulitis, Frozen Shoulder is a condition where the shoulder becomes painful, stiff and loses much of its ability to move, often feeling ‘frozen’ in one place. This is thought to be caused by scar-like tissue forming in the shoulder capsule. In peak health, the shoulder capsule measures just a couple of millimetres in width, and it stretches freely when the arm is moved. When you experience ‘Frozen Shoulder, this capsule can grow to more than a centimetre, vastly reducing its ability to stretch or move with the joint.

It is not known precisely what causes this tissue around the capsule to build. There are, however, certain demographic groups at a greater of risk of developing the condition:

  • Those in the 45-60 age bracket
  • Diabetics
  • People with an overactive thyroid
  • Those with existing shoulder injuries or who are post-shoulder surgery
  • Anyone with experience of serious health conditions such as heart disease and stroke
  • People with Dupuytren’s Contracture – a condition where small lumps of thickened tissue form in the hands and fingers

Frozen Shoulder is a steadily progressing condition lasting anywhere from 1.5 to in excess of 3 years. Comprising of three phases, there is enormous variation in the length and severity of symptoms.

Phase One – the painful ‘freezing’ phase where mobility is reduced or lost. Typically lasting 2-9 months, you may find the pain is worse at night and when lying on the affected side.

Phase Two – Next comes the ‘frozen’ or ‘adhesive’ stage, lasting anywhere between 4-12 months. Here the pain may gradually subside, yet the rigidity and movement restriction remains, and can deteriorate. All shoulder motion is impeded, however, the most severely affected movement tends to be the outward rotation of the arm.

Phase Three – The ‘thawing’ or recovery phase. Lasting typically between one and three years, the pain and stiffness gradually dissipate, allowing function to return to normal.

Shoulder muscles waste due of lack of use.

Symptoms often interfere with everyday tasks such as driving, dressing, or sleeping. Even scratching your back, or putting your hand in a rear pocket, may become impossible. Work may be affected in some cases.

There is great variation in the severity and length of symptoms. Untreated, on average the symptoms last 2-3 years in total before going. In some cases, it is much less than this. In a minority of cases, symptoms last for several years.

As ever, a prompt, professional diagnosis should be sought early on with a Frozen Shoulder. Physiotherapy intervention in the initial stage can dramatically reduce the duration and severity of the condition, and avoid unnecessary muscle wastage in the area due to prolonged lack of use. Treatment goals are primarily to minimise the pain and secondly, to regain and maintain movement of the shoulder. Depending on the stage of your condition, appropriate treatment may include exercises to build flexibility, local injections to reduce the inflammation of the joint or in extreme cases, a recommendation for surgery may be necessary to resolve the problem. Even if you notice stiffness that is but slightly increasing or that is not yet problematic, you are best to seek advice from the onset of any symptoms and shouldn’t wait for them to worsen.

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