Frozen shoulder, or adhesive capsulitis, causes pain and stiffness in the shoulder joint. It affects about two percent of people and is more common in women aged 40 to 70 years old. People with diabetes are at higher risk. Frozen shoulder can occur after an injury, especially if a sling is used for some time.
The causes of frozen shoulder are unknown. However, frozen shoulder does cause thickening and tightening of the lining of the shoulder joint.
Symptoms - Shoulder pain is usually dull or aching. It is worsened when the shoulder is moved. The pain is usually felt over the outer shoulder and sometimes the upper arm.
Stiffness in the shoulder causes a loss of normal shoulder movement.
Investigations - Usually frozen shoulder can be diagnosed based on the patient’s history and examination findings. Shoulder X-rays are always taken to rule out other causes of shoulder pain and stiffness such as arthritis. MRI scans are sometimes needed.
Treatment - Most people with frozen shoulder will get better without treatment in time. This may take up to 2-3 years and some stiffness may remain.
Non Operative Treatment
Medications such as painkillers and anti-inflammatories may reduce pain. Oral steroids or corticosteroid injections may also be used.
Physiotherapy can be used to try and return movement using stretching and exercise.
Hydrodilitation is carried out in the X-ray department and involves injecting fluid into the shoulder to stretch the lining of the joint and improve movement. It does cause some pain.
Manipulation under Anaesthesia involves moving the shoulder while the patient is asleep. This causes the lining of the shoulder to tear or stretch and movement to improve.
Shoulder Arthroscopy is ‘key-hole’ surgery in which a camera placed inside the joint through small cuts. Using the camera and special tools the tight parts of the joint lining are cut and better movement occurs.
Most patients who require an operation have good results. Physiotherapy is important after surgery to maintain and improve movement.
After surgery, recovery may take 6 weeks to 6 months. Some patients require 2 to 6 weeks off work following surgery, depending on their job and speed of recovery.