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Frozen shoulder - Orthopaedics SA

Frozen Shoulder

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

Shoulder movement is dependent on the correct alignment of the surrounding supporting joint lining (or capsule). In adhesive capsulitis, the shoulder joint lining becomes inflamed causing scar tissue to form. This in turn severely reduces (or freezes) the shoulder's range of movement and is often associated with significant joint pain. Restricted movement of the shoulder accompanied by persistent pain contributes to the frozen status of the joint.

  • 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 and tissue is replaced by less elastic scarred tissue.
  • 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.

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.

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

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

Treatment can include anti inflammatory medication; a ‘hydro-dilatation’ with either saline or steroid injections; and physiotherapy aimed 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 Surgeon may elect to perform a shoulder manipulation under general anaesthesia to help stretch the scar tissue and encourage movement of the joint. This is often accompanied by arthroscopic (key-hole) surgery, aimed at removing scar tissue and adhesions before manipulating the joint to improve movement.

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