Frozen shoulder

Photo: Contributed

Frozen shoulder, also known as adhesive capsulitis, is a condition of the glenohumeral (shoulder) joint that results in pain and restriction of range of motion (ROM). This condition affects 2% to 5% of the population and is more frequent in women than in men, often present between 40 to 60 years of age. Anatomically, frozen shoulder is characterized by the thickening and tightening of the joint capsule, a specific type of tissue surrounding the shoulder joint, which results in the restriction of motion. Over time, frozen shoulder often presents with painful, progressive loss of both active (movement is performed by the patient without any assistance) and passive (patient is assisted with movement) ROM. This decreased mobility often follows a particular pattern in which lateral rotation is most affected, followed by abduction (raising the arm out to the side), and then medial rotation. There are 4 stages of frozen shoulder, which are as follows:

1. Painful Stage: Symptoms include an aching pain of the shoulder and moderate limitation of ROM. Pain occurs at rest and is often bothersome at night. Pain is aggravated by movement of the shoulder. This stage often lasts for up to 3 months.

2. Freezing Stage: Symptoms include severe pain and significantly reduced ROM. Abduction, internal and external rotation are the most affected movements. This stage persists for 3 to 9 months after symptom onset.

3. Frozen Stage: Symptoms include stiffness and restriction of movement in every direction. Pain is minimal or only at extremes of ROM. This stage is often present 9 to 15 months after the onset of symptoms.

4. Thawing Stage: Pain has decreased and ROM begins to improve. This stage can persist from 15 to 24 months after onset of symptoms.

As you can see from the above stages, frozen shoulder can persist for up to 24 months from the initial onset of symptoms. There are many types of treatments that may be suggested by your physician, including physiotherapy, anti-inflammatory medications, injections, as well as surgical interventions. As a physiotherapist, two main principles for the treatment of frozen shoulder include restoring ROM and reducing pain. Physiotherapy techniques often used to treat frozen shoulder include modalities (laser, ultrasound, electrotherapy, hot/cold therapy), stretching, manual mobilization of the shoulder joint, and prescribed home exercise programs.

Please check with your primary health care provider to determine a diagnosis for your shoulder pain and if any of the above treatments may be of benefit to you.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.