What is Frozen Shoulder?

Frozen shoulder, or adhesive capsulitis, is a common idiopathic condition which impairs the daily activities of living of individuals, especially those in the middle-aged group.

Clinically, it is identified as shoulder pain with restrictions in both active and passive shoulder range of movements. Shoulder comprises of upper arm, shoulder blade and collarbone. There are also tissues surrounding the shoulder that secures everything together with muscles called the shoulder capsule. With frozen shoulder, there is inflammation of the shoulder capsule as well as synovial lining leading to limitation of movements.

“Frozen shoulder, or adhesive capsulitis, is a common idiopathic condition which impairs the daily activities of living of individuals, especially those in the middle-aged group”

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So what are the symptoms and stages of Frozen Shoulder?

Symptoms of Frozen Shoulder include Insidious onset of pain and decrease in active and passive range of movement particularly lose of external rotation and overhead movements.

Patients with Frozen Shoulder typically go through the following stages:

Stage 1: Freezing / Pain

Duration: 3-9 months

Pain and stiffness around the shoulder with no history of injury. A nagging constant pain is worse at night, with little response to non-steroidal anti-inflammatory drugs

Stage 2: Frozen / Adhesive

Duration: 4-12 months

The pain gradually subsides but stiffness remains. Pain is apparent only at the extremes of movement. Gross reduction of glenohumeral movements, with near total obliteration of external rotation.

Stage 3: Thawing / Resolution

Duration: 12-42 months

Follows the adhesive phase with spontaneous improvement in the range of movement. Mean duration from onset of frozen shoulder to the greatest resolution is over 30 months.

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Causes & Risk Factors

Frozen Shoulder occurances are usually idiopathic. In other words, there are usually no particular reasons for its occurance.

However, at times, Frozen Shoulder occurances can also happen post-injury or post-surgery

Risk Factors for Frozen Shoulder include Diabetes Mellitus, Stroke, Shoulder Injuries, Thyroid Conditions, Parkinson's, Tuberculosis, Cancer History, and Systemic Conditions.

Frozen Shoulder Treatments

Frozen Shoulder can be treated via non-surgical or surgical means. Non-surgical options includes physiotherapy, pharmaceuticals, corticosteroid injections, and sodium hyaluronate injections. Surgical options include manipulation under anaesthesia and arthroscopic capsulotomy.

How can we help?

Physiotherapy is important in providing proper education and exercises in assisting with shoulder movements. It is important to emphasize on quality instructions and create appropriate exercise program that is easy to comprehend and adhere to. Also, physiotherapist also can provide techniques to assist with improving range of movements.

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Your health is very important to us.

Regardless of where you intend to seek physiotherapy treatment, if you are experiencing any pain / discomfort, we encourage patients to get a consultation with our physiotherapists as soon as possible.