Frozen Shoulder: What to Expect?

Frozen Shoulder

Adhesive Capsulitis, more commonly known as Frozen Shoulder, is a debilitating, inflammatory condition characterised by pain and a significant reduction in mobility within the shoulder capsule. In most cases, the condition lasts a minimum of 3 months. The term ”Frozen Shoulder” was first introduced by Ernest Codman in 1934, describing it as a ”condition of insidious onset associated with stiffness and difficulty sleeping on the affected side. While the Frozen Shoulder usually has a slow, progressive start, symptoms can manifest quickly and take up to 2-3 years to resolve (without treatment).

What Causes Frozen Shoulder?

We don’t fully understand what causes a frozen shoulder, but an inflammatory process is probably involved. However, some contributing factors have been identified. These include:

    1. Diabetes
    2. Stroke
    3. Thyroid disorder
    4. Shoulder injury
    5. Dupuytren disease
    6. Parkinson disease
    7. Cancer
    8. Complex regional pain syndrome

There is also a risk of a Frozen Shoulder Developing after any surgery or procedure that prevents you from moving your arm for an extended period. It is estimated to impact up to 5% of the population, with females being four times more likely to be affected. People aged between 35-50 years old are at the highest risk of developing a Frozen Shoulder. 

Stress is another big player. One of the predictive markers of Frozen Shoulder is prolonged inflammation, essentially resulting in inflammation of the capsule and tissue surrounding the shoulder joint. A recent study found intense stress over-activates the immune system, leading to the imbalance between inflammation and anti-inflammation levels within the body. Furthermore, shoulder tension is a common symptom of stress. Your body’s fight or flight stress response causes shoulder tension as a way to prepare and confront a perceived physical threat. While that may be useful when a honey badger  is attacking us, a constant state of stress and shoulder tension in the urban world increases the risk of a Frozen Shoulder.   

Frozen Shoulder
What Are The Symptoms Of A Frozen Shoulder?

The symptoms of Frozen Shoulder are dependent on the progression of the condition, which is split into three categories: 

  • Freezing Stage (2-9 months): Significant Pain in the shoulder exacerbated by any movement. Pain is usually worse at night. Stiffness of the shoulder is mild. 
  • Frozen Stage (4-12 months): Pain begins to lessen. Stiffness increases substantially, especially in external rotation. 
  • Thawing Stage (5-24 months): Pain is minimal, followed by a gradual return in the range of motion. 

The severity and length of symptoms can vary from person to person. Frozen Shoulder is considered debilitating due to simple daily tasks like taking a book off an overhead shelf or fastening a bra becoming impossible. While uncommon to relapse Frozen Shoulder on the same side after recovery, it can happen, although the chance of developing Frozen Shoulder on the opposite shoulder is much higher. 

What Are The Symptoms Of A Frozen Shoulder?

The symptoms of Frozen Shoulder are dependent on the progression of the condition, which is split into three categories: 

  • Freezing Stage (2-9 months): Significant Pain in the shoulder exacerbated by any movement. Pain is usually worse at night. Stiffness of the shoulder is mild. 
  • Frozen Stage (4-12 months): Pain begins to lessen. Stiffness increases substantially, especially in external rotation. 
  • Thawing Stage (5-24 months): Pain is minimal, followed by a gradual return in the range of motion. 

The severity and length of symptoms can vary from person to person. Frozen Shoulder is considered debilitating due to simple daily tasks like taking a book off an overhead shelf or fastening a bra becoming impossible. While uncommon to relapse Frozen Shoulder on the same side after recovery, it can happen, although the chance of developing Frozen Shoulder on the opposite shoulder is much higher. 

How to Treat or Release a Frozen Shoulder?

If you’re starting to show symptoms of Frozen Shoulder; it’s best to book an appointment with your GP to get a confirmed diagnosis. In most cases, a simple physical assessment of mobility within the shoulder is enough. In rare circumstances, an X-Ray or MRI may be required; however, this is mainly to rule out other shoulder problems such as arthritic changes, dislocation, and rotator cuff tears. 

The treatment of Frozen Shoulder is mainly focused on pain relief and restoring the normal range of motion within the shoulder. In most cases, the Frozen Shoulder will unfreeze itself with time; pain relief medications such as Ibuprofen, Diclofenac, and Paracetamol can be prescribed to mitigate the process. In severe cases with immense shoulder pain, Cortisone injections may be required. Using ice packs to manage pain is also effective. A recent study found that using Extracorporeal Shockwave Therapy had positive effects on treatment, quicker return to daily activities, and quality-of-life improvement on frozen shoulder. At our clinic we find that extracoroporeal shockwave works extremely well for frozen shoulders and does so without any of the nasty downstream side effects of other treatment options.

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