What is the Best Treatment for Frozen Shoulder?

What is a Frozen Shoulder?

A frozen shoulder, also known as adhesive capsulitis, is a common condition that causes stiffness, pain and a loss of normal motion in the shoulder. A frozen shoulder can cause significant disability and may get worse over time if left untreated. Women are affected more often than men, and this condition mainly affects people aged 40 to 60 years.

 

What Causes a Frozen Shoulder?

Currently there is still a lot that is not known regarding the cause of a frozen shoulder. However, inflammation is most likely to be involved. Sometimes a frozen shoulder may occur because the shoulder has been immobilised for a period of time due to injury, illness or surgery. However, in many cases the cause is unclear.

Frozen shoulder tends to be more prevalent in those with certain conditions including cardiovascular disease, diabetes and thyroid conditions. Researchers are not sure why this is the case. A frozen shoulder also occurs more frequently after surgery.

Often a frozen shoulder happens following inflammation of the soft tissue due to overuse injuries such as tendinitis. Or it can be due to an acute injury such as a fracture. When the shoulder is immobilised, the surrounding connective tissue of the joint capsule contract and thicken, reducing its capacity to stretch. Avoiding movement due to pain may even cause further contraction of the joint capsule. 

How is a Frozen Shoulder Diagnosed?

A frozen shoulder is diagnosed through a physical assessment. The range of motion of the shoulder is assessed through various movements; for example, reaching across the chest to touch the other shoulder or reaching down the back and touching the opposite shoulder blade. Further tests such as X-rays may be necessary to eliminate any underlying problems such as a structural restriction or arthritic changes.

A frozen shoulder is also diagnosed through questioning the patient about certain daily tasks that may have become difficult or painful to perform, such as:

  • Throwing a ball
  • Reaching above shoulder height
  • Reaching behind the back
  • Reaching quickly for something
  • Sleeping on the affected side
  • Reaching to the side

 

How is a Frozen Shoulder Treated?

Treatment initially focuses on reducing pain and inflammation, then restoring the shoulder’s normal range of motion. Manual treatment may be helpful at certain stages. The main method of returning the shoulder back to normal is through physiotherapy.

 

Is Physiotherapy Good for a Frozen Shoulder?

Physio for a frozen shoulder usually concentrates on manual therapy and exercise to stretch the joint capsule in the early stages. It also includes releasing secondary muscle spasm and other local joint stiffness such as in the neck or thoracic spine. Eventually strengthening exercises are also added. Physiotherapy in Perth prescribes appropriate exercises to suit each patient, being careful to stay within their limits. Once a patient has learnt their limitations and understands the exercises well, they can practice at home.

 

Is Surgery Necessary for a Frozen Shoulder?

Surgery may only be considered if there is a lack of recovery after the appropriate physio program has been completed. However, the majority of frozen shoulder cases resolve within 18 to 24 months, and 60 to 80% of patients respond well to physiotherapy.

 

Is a Frozen Shoulder Preventable?

Although the cause of a frozen shoulder is often unknown, there are ways to reduce the risk. In the case of a shoulder injury, it is advisable to seek professional advice and management from a physiotherapist. This may help to prevent a secondary frozen shoulder.

 

A frozen shoulder is a common cause of shoulder pain in people aged 40 to 60 years. A frozen shoulder is often associated with inflammation which reduces the arm’s range of motion. In most cases, a frozen shoulder is treatable without surgery, and physiotherapy in Perth is effective in the majority of cases.



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