Ask the Expert – Frozen Shoulder

Ask the Expert – Frozen Shoulder

(Dr Geoff Davies, Western Mail 27th February 2012)
Click here to read article on Wales Online

My doctor says I have a frozen shoulder. What exactly is it?
Frozen shoulder is also known as adhesive capsulitis. This is a condition where the joint capsule of the shoulder becomes tight and painful resulting in reduced movement of the joint. It usually occurs spontaneously without the shoulder having been injured.

What causes a frozen shoulder?
The exact cause is unknown. However, it is thought that the capsule shrinks, causing shoulder stiffness which restricts movement. Sometimes it can occur following an injury or shoulder operation but usually it can happen with no warning. and for no specific reason.

Who gets a frozen shoulder?
Frozen shoulder commonly occurs in people aged 40-60 and is usually more common in females and diabetics, and usually affects the non-dominant shoulder. This means if you’re right-handed, your left shoulder is more likely to be affected and vice-versa. Patients who have had a frozen shoulder have an increased risk (around 20%) of developing a similar problem on the other side.

How is it diagnosed?
Usually the diagnosis is made by a doctor or physiotherapist. No special tests are usually required although an x-ray may occasionally be needed to rule out osteoarthritis of the shoulder.

What should I expect?
The typical symptoms are pain, stiffness and reduced shoulder movements. Three phases are typical, these being the freezing phase, frozen phase and thawing phase. Unfortunately, symptoms can persist for many months and can be quite debilitating.

How is it treated?
Treatment of the condition is slow and it can take a prolonged period of time for the patient to fully recover. Usually frozen shoulder is treated with pain-killers and anti-inflammatory medications. Patients may be offered a steroid injection into the shoulder joint which can help with pain control., and can also facilitate progress with physiotherapy The injection in itself does not improve shoulder mobility. Physiotherapy is commonly used to treat frozen shoulder by improving mobility. of the shoulder.

What if this does not work?
Severe cases may require a surgical procedure particularly if the shoulder is causing problems with daily activities. A surgeon can perform a manipulation of the shoulder under anaesthesia or a keyhole surgical release of the shoulder capsule. However, most people do not ultimately require surgery.