Frozen Shoulder

You have been diagnosed with frozen shoulder.  Now what?  What is it and how can physiotherapy help?

The first thing to do is learn the medical term for the condition. It sounds more impressive and will garner more sympathy from your friends when you tell them you have adhesive capsulitis vs. frozen shoulder. Although the term adhesive capsulitis may sound technical; when broken down it is very descriptive.

The shoulder, like most joints, is surrounded by a wet leather sack called the joint capsule. The suffix –itis simply means inflammation ie. Tendonitis is inflammation of a tendon and you can guess what is inflamed when you have tonsillitis.  So capsulitis indicates that the capsule surrounding the shoulder joint is inflammed. Adhesive is a description of what is happening to the capsule – it adheres, scars, and shrinks. Adhesive capsulitis thus describes a joint capsule that is inflammed, scarred, tightened and adhered. Understanding these terms makes it easy to predict the primary symptoms of the condition - decreased range of motion and pain. This likely sounds familiar to your current symptoms.  One of the first complaints many sufferers of frozen shoulder have is that of not being able to reach behind their back to get their wallet, or not being able to reach above their head to brush their hair – and pain – we won’t forget about the pain.

Signs and symptoms usually begin gradually and worsen over time. Many patients are perplexed as they can not recall anything that they may have done to cause their shoulder pain.  The answer is usually nothing.  Although some frozen shoulders are due to immobilization after injury like stroke or mastectomy; most just happen – and although there are theories on why it occurs, the medical community can not explain it fully.  Frozen shoulder is most common between the ages of 40-60, it occurs in women more than men,and is reported to affect 1 in 30 people. 

Frozen shoulder typically develops slowly, and progresses through three stages.

• FREEZING STAGE – Pain is reported with any shoulder movement and range of motion progressively becomes more and more limited.
• FROZEN STAGE – Although pain may begin to diminish, the shoulder becomes even stiffer.
• THAWING STAGE – The range of motion of the shoulder begins to improve.

Frozen shoulder is relatively easily to diagnose when a complete orthopedic examination is performed by your physiotherapist.  Once your diagnosis of frozen shoulder has been confirmed treatment may begin.  Initial treatment emphasizes pain control and preserving as much shoulder range of motion as possible. You will play an active role in your rehabilitation as your therapist will provide you with a home exercise program including range-of-motion exercises.  Your doctor may also prescribe pain-relieving and anti-inflammatory drugs to control pain.

And now the best news of this entire article – frozen shoulders get better and a complete recovery is expected.  And the bad news to go with the good news – most frozen shoulders take 12-18 months to resolve.