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Following on from last month’s column I’d to discuss a more specific cause of shoulder pain and stiffness- frozen shoulder. In medical terms this is known as Adhesive Capsulitis. It is condition that is relatively poorly understood, with many people being diagnosed with frozen shoulder incorrectly.

 

It differs from many shoulder conditions in that the restriction of shoulder is usually in all directions, not just painful in one or two. It also has three distinct phases:

 

  • Phase one – the ‘freezing’, painful phase. This typically lasts 2-9 months. The first symptom is usually pain. Stiffness and limitation in movement then also gradually build up. The pain is typically worse at night, and when lying on the affected side.
  • Phase two – the ‘frozen’, stiff phase. This typically lasts 4-12 months. Pain gradually eases but stiffness and limitation in movement remain and can get worse. All movements of the shoulder are affected but the movement most severely affected is usually rotation of the arm outwards. The muscles around the shoulder may waste a bit as they are not used.
  • Phase three – the ‘thawing’, recovery phase. This typically lasts 5-24 months. The stiffness gradually goes and movement gradually returns to normal, or near normal.

Symptoms often interfere with everyday tasks such as driving, dressing, or sleeping. Even scratching your back, or putting your hand in a rear pocket may become impossible. Work may be affected in some cases. There is great variation in the severity and length of symptoms. Untreated, on average the symptoms last 1-2 years in total before going. In some cases it is much less than this. In a minority of cases, symptoms last for several years.

As the medical name suggests, the cause for this level of pain and stiffness seems related to the capsule or bag surrounding the ball and socket joint in the shoulder, in which the tissue within the back becomes inflamed and thickens. This sometimes follows trauma but for many the cause is unknown.

Treatment is aimed at reducing the level of pain with muscle stretching, massage and exercise, and is ultimately aimed at reducing the resulting restriction of movement once the pain subsides.

As with all medical conditions a correct diagnosis is of paramount importance for the appropriate treatment and management of the condition. For more information on the clinic, to discuss a particular case, or to book and appointment please call Tristan Hill on 07835596870