Definition
Frozen shoulder, also known as adhesive capsulitis, is a condition characterised by stiffness, pain, and limited range of motion in the shoulder joint. It typically progresses through stages and can be associated with inflammation and the thickening of the shoulder capsule. The exact cause is often unknown, but it can be linked to injury, diabetes, or thyroid disease.
Clinical Presentation
The clinical presentation of frozen shoulder typically involves progressive symptoms that evolve through stages. These stages are:
- Pain (Stage 1 – Painful stage)
- Gradual onset of shoulder pain.
- Pain tends to worsen at night.
- Initially, there may be a vague discomfort that intensifies over time.
- Stiffness (Stage 2 – Frozen stage):
- Increasing stiffness and decreased range of motion in the shoulder.
- Difficulty in performing daily activities that require arm movement, such as reaching overhead or behind the back.
- Thawing (Stage 3 – Thawing stage):
- Gradual improvement in pain and stiffness.
- Range of motion begins to return, but complete recovery may take several months to years.
- Some individuals may experience mild residual stiffness or limited range of motion even after the resolution of the primary symptoms.
It’s important to note that the clinical presentation can vary among individuals, and the progression of frozen shoulder may differ.
Treatment Options
The treatment of frozen shoulder aims to minimise symptoms of pain and stiffness and optimise shoulder function until such time as the condition naturally resolves. The approach may involve a combination of conservative measures and, in some cases, more invasive interventions. Here are common treatment options:
- Pain Management:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) or over-the-counter pain relief can help manage pain and reduce inflammation.
- Physiotherapy:
- Physiotherapy can plays a beneficial role in frozen shoulder treatment, by optimising range of movement and strength, within the bounds of comfort.
- Heat or ice applications may be used to alleviate pain and reduce inflammation.
- Interferential treatments such as massage, dry needling, and others may also be of benefit in providing symptomatic relief for some patients.
- Joint Distension (Hydrodilatation)
- In some cases, a doctor may inject sterile water or a combination of saline and corticosteroids into the joint capsule to stretch and expand it, relieving pain and reducing stiffness.
- Corticosteroid Injections:
- Corticosteroid injections directly into the shoulder joint can help reduce inflammation and alleviate pain.
- Surgery (Release or Arthroscopic Capsular Release):
- If conservative measures fail, a surgeon may perform an arthroscopic capsular release, where tight portions of the joint capsule are cut to improve movement.
- This operation is best performed during the thawing stage, once the pain and inflammation have resolved.
To schedule an appointment with Dr Matthew Evans to discuss your Frozen Shoulder, please contact us by phone – (03) 9529 3820, or email evansadmin@mog.com.au
