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Frozen shoulder

Frozen shoulder or adhesive capsulitis can occur as an isolated event or following a fracture, dislocation or other trauma where there may be reduced shoulder motion over a period of time.

Mobility in the shoulder is dependent on the correct alignment of the surrounding supporting ligaments. In adhesive capsulitis, the ligaments become inflamed causing scar tissue to form. This in turn severely reduces (or freezes) the shoulders’ range of movement and cause significant joint pain. Restricted movement of the shoulder accompanied by persistent pain contributes to the frozen status of the joint.

While research has indicated that some medical conditions such as diabetes, heart disease and arthritis can be associated with frozen shoulder the condition can occur spontaneously where there may appear to be no obvious cause.

Symptoms

  • People with frozen shoulder will report increased shoulder pain associated with reduced joint movement. This is the first of three phases during which the shoulder ‘freezes’.
  • Joint pain may become more localised during the ‘frozen’ stage as the inflammation subsides.
  • Patients often report poor sleep patterns due to increased pain at night.
  • The third phase occurs as the condition begins to resolve and scar tissue produced during the initial stage begins to loosen.
  • It may take considerable time for the condition to enter the ‘resolution’ phase, so treatment is aimed at speeding up the process as much as possible.

Diagnosis

Diagnosis is usually made during a physical examination where shoulder pain, together with reduced flexion and rotation is observed.

If required, other investigations such as x-rays or ultrasound may be arranged to assist the diagnosis.

Treatment

Treatment can include anti inflammatory medication, steroid injection, physiotherapy and a home exercise program to encourage gentle motion in the joint and to prevent the formation of further scar tissue.

If the condition is severe and unresponsive to conservative treatment, your Doctor may elect for a shoulder manipulation under general anaesthesia to help stretch the scar tissue and encourage movement back into the joint.

Arthroscopic surgery to remove scar tissue and adhesions can be done in extreme cases.