Frozen shoulder is a common condition, the causes of which have baffled researchers and people who suffer from the condition, which can come on unexpectedly. It can be a very painful and difficult condition to live with on a day-to-day basis.
If you suspect you have frozen shoulder, ask yourself the following questions:
Have you ever tried to move your arm to find an unexplained pain or dull ache right in the middle of your shoulder joint?
Or perhaps you’ve had some pain in your shoulder for a while and it’s beginning to stiffen so that it’s becoming harder to move your arm?
Or maybe you used to have pain which has now receded but your arm and shoulder joint has a very small range of motion?
If you’ve answered yes to any of these questions, your symptoms point to frozen shoulder.
What is frozen shoulder?
Frozen shoulder – otherwise known as adhesive capsulitis – is a condition which causes pain and stiffness in your shoulder joint. (1) Some other painful conditions of the shoulder such as rotator cuff spasm, supraspinatus tendonitis and bursitis are commonly referred to as ‘frozen shoulder’.
To explain what happens when frozen shoulder occurs, a brief explanation of how your shoulder works is helpful.
Within the shoulder joint, there are three bones working together to allow your arm to move with a full range of motion – your humerus (upper arm), scapula (shoulder blade) and clavicle (your collarbone). (2)
The top of the upper arm bone slots into a socket on the shoulder blade forming the glenohumeral joint. This joint is held together by tough connective tissues known as the shoulder joint capsule and ligaments. The joint capsule surrounds the joint and is lined with tissue known as the synovial membrane. The synovial membrane produces a watery fluid known as synovial fluid. Proper joint movement is helped by lubrication afforded by synovial fluid.
In order to allow your shoulder to have a large range of motion, the capsule and ligaments have to be quite lax. Part of the task of maintaining shoulder joint integrity falls on the muscles that move the joint – especially, the rotator cuff muscles.
In some cases of frozen shoulder, the connective tissue holding the upper arm bone in place can become thick and tight, forming stiff bands of tissue called adhesions. These can limit the movement of your shoulder joint, causing it to become painful and difficult to move. This condition is known as adhesive capsulitis.
In other cases, some or all of the rotator cuff muscles have gone into spasm, painfully limiting the movement of the joint and hence being called ‘frozen shoulder’.
Why is it called frozen shoulder?
You’ll be pleased to know there is no actual freezing of the shoulder; it’s really used as a metaphor to describing how the joint feels during the cycle of the condition. This cycle may have three distinct phases, which are described in terms of ‘freezing’, as you’ll see:
The first phase: freezing
This is the most painful stage of the condition which can last between two to nine months. During this time, certain movements will trigger the pain – it may be worse at night and hurt if you lie on your shoulder. During this phase, your shoulder will also start to stiffen and your range of movement will gradually become limited.
The second phase: frozen
This is the stage when the stiffness is at its worst with very little range of motion in your shoulder, even though pain from the shoulder joint may have lessened and disappeared altogether. This stage can last for up to a year and lack of movement may actually see your muscles weaken as they’re not being used.
The third phase: thawing
This is the recovery stage, when your arm’s range of movement slowly improves until returning to normal. This may happen naturally without any intervention, although it could last up to several years.
As you can see, the length of time you’re affected by frozen shoulder can vary greatly. Some studies suggest around 50% of people suffering from frozen shoulder experience symptoms up to seven years on from when the condition first started (3), which is a considerable time to have to live with the effects of frozen shoulder.
Why have I got frozen shoulder?
That’s a very interesting question… no-one is really certain why frozen shoulder occurs in some people.
(Sources can’t even agree on how common the condition is. Some sources claim frozen shoulder affects up to 5% of the population (4), while others put the estimate higher at 20% (3))
However, there are a few factors and indicators which help identify whether you’re at risk.
For example, your chances of having frozen shoulder are likely to be higher if you female and between 40 to 60 years old.(2) You’re also more likely to suffer if you’re older – 72% of frozen shoulder patients are over 50.(6)
If you have diabetes, frozen shoulder is more common than average, while it also affects people with heart disease and stroke more.
If you’ve had surgery or an injury affecting your shoulders or arms this could be a factor. It is important to ensure you start moving your arm and shoulder as soon as possible after surgery to ensure there is a full range of motion.
How do you treat frozen shoulder?
Although frozen shoulder can be very painful, in many cases it will get better over time. However, this can take several years and if you don’t relish the thought of suffering for this length of time, the good news is various treatments are available to help manage the pain and speed recovery.
Getting back to normal is perfectly feasible. The vast majority of patients – more than 90% – only require simple treatment to deal with and alleviate the problem of frozen shoulder, and return the shoulder to its full range of motion.(2)
In most cases, soft tissue work may greatly improve the condition. By working towards restoring range of motion and managing pain, one can progress gently towards easing symptoms.
You may also benefit from a number of shoulder exercises, recommended by your chiropractor, which will help loosen the shoulder and manage the pain.
Acupuncture, in conjunction with physical therapy, may also help assist patients recovering from frozen shoulder in managing pain, reducing inflammation, muscle and joint stiffness.(5)
Laser therapy has been shown to be effective in reducing the pain associated with frozen shoulder and for improving function in these cases. (7)
Undergoing surgical treatment or steroid injection may only be necessary in a small number of cases.
Often a combination of the two is used and therapy is usually required from six weeks to six months to ensure the shoulder regains its full range of motion.
Although the causes of frozen shoulder are still unexplained, in most cases this common condition is easily treatable and needn’t interfere with your life. The condition will correct itself after a period of time, but living with the pain and poor range of motion during this period may not be practical or bearable for you. Fortunately, there are a range of treatment options available.
If you are affected or think you may be affected by the condition, Wokingham Chiropractic have a wealth of experience dealing with musculoskeletal conditions. Call us on 0118 978 7466 to speak to us.
Sources:
- Frozen shoulder Definition – Mayo Clinic https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/basics/definition/con-20022510
- Frozen shoulder – American Academy of Orthopaedic Surgeons https://orthoinfo.aaos.org/topic.cfm?topic=a00071
- Frozen shoulder – NHS Choices https://www.nhs.uk/conditions/Frozen-shoulder/Pages/Introduction.aspx
- Frozen shoulder diagnosis – Simeon Niel-Asher – Frozenshoulder.com https://www.frozenshoulder.com/frozen-shoulder-diagnosis.php
- A study on the clinical effects of physical therapy and acupuncture to treat spontaneous frozen shoulder – Ma T et al. Am J Chin Med 2006
- Frozen shoulder: symptoms, diagnosis, treatments and self-care – Saga.co.uk httpss://www.saga.co.uk/health/body/frozen-shoulder-symptoms-and-treatment.aspx
- Systematic review of the therapies used to treat frozen shoulder, including Low Level Laser Therapy –
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