Frozen Shoulder / Adhesive Capsulitis

1. What is causing the pain and how did I get it?

Frozen means stiff, and indeed this is a painful and stiff condition affecting the shoulder joint.

A shoulder joint (or any other joints) can become stiff once we stop moving it. We stop moving initially due to various reason, a fracture, a small tear to surrounding muscles, and an impingement.  Some patients report that the shoulder cease up for no reason. We termed these idiopathic frozen shoulder. These patients tend to be female, above 40 years old, may have diabetes.

But the key is when we stop moving the joint, it can potentially become very stiff and the shoulder is particularly venerable to it. Frozen shoulder can be divided into 3 stages: Freezing, frozen and thawing stage

 

Freezing: This is where the pain is acute and is any shoulder movement is painful.  (Duration of 0 to 3 months)

Frozen: The pain now is somewhat lesser than during the freezing stage but the shoulder now is very stiff. And the pain comes on when you lift up the shoulder to the end. (Duration 3 to 9 months)

Thawing:  This is when the shoulder joint start to regain the range of motion (Duration 9 to 18 months)

 

2. How can physiotherapy help?

Treatment will depend which stage you are at:

Freezing stage:  Anti-inflammatory drugs from the doctors will be useful to manage the pain, gentle physiotherapy is aim at maintaining your flexibility and posture.  At this stage, it is important to let the shoulder settle down.  Avoid heavy lifting activities.

Frozen stage: Physiotherapy will be slightly more aggressive to prevent more stiffness from settling in.  Home exercises are important to maintain your range of motion.

Thawing stage: Physiotherapy is now aim at getting back as much flexibility as possible.  Treatment includes

  • Manual therapy, where the physiotherapist will use theirs skills to stretch your shoulder
  • Home stretching exercise programme
  • Strengthening and postural exercises

 

3. How can I help?

BMJ encourage patient to bring in their partners, spouses, family members to take part in therapy.

 

4. How long will it take to recover? (ie prognosis)

Full recovery can sometimes take 3 to 6 months.  Patient must be psychologically prepare for this long haul treatment.

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