The technical name for frozen shoulder is “adhesive capsulitis”, which gives a good idea of what’s happening in the joint. Surrounding the ball and socket joint of the shoulder, there is a capsule of soft tissue. It’s a flexible material that allows the shoulder to move properly and keeps the joint fluid inside.
But in frozen shoulder it becomes sticky (or “adhesive”). This causes restricted movement and pain, particularly in the movements illustrated below.
Factors involved in developing Frozen Shoulder
Often it is unclear why this develops. Sometimes it may follow trauma, including surgery, but other times it has no identifiable trigger. We do know that some other conditions are associated with a higher risk of adhesive capsulitis, such as:
- Parkinson’s disease
- Heart disease
There’s also a link to immobilised shoulders. This is one reason you don’t want to wear a sling unnecessarily for mild shoulder or elbow injuries. It is unclear how this predisposes a shoulder to freeze, all we know is that it happens.
Finally, as one shoulder “thaws”, there is a relatively high incidence of the other one freezing. Again, the reason why is unclear.
Prognosis for Frozen Shoulder
Unfortunately, this is not a quickly resolving condition. The good news is that it appears to be self-limiting, and responsive to conservative treatment. It can be broken down into three stages, each with their own timeframe.
The first stage is called the freezing stage. This covers from the first changes to the point of most restricted movement.
This period is the most restricted in terms of movement, but not necessarily the most painful. Pain from the freezing stage begins to resolve, or at least doesn’t get any worse.
The frozen stage has a very variable timeframe, lasting somewhere between 4 and 20 months. This period may be reduced by manual therapy.
The tail end of the resolving stage can be long and drawn out. But as both pain and movement are improving, it might not feel so long.
Similar to the frozen stage, thawing can last from 5 to 26 months.
Encouraging movement from the joint and surrounding muscles in the treatment room can benefit the shoulder. Limiting maximum lost movement and speeding up the three stages is the aim in treatment.
Medication is the second line of treatment. Anti inflammatories, including both NSAIDs and steroids can be prescribed for frozen shoulder. Sometimes a steroid injection will also be offered, although there are long term side effects of steroid injections, and no real long term benefits for this condition. Surgery is another option, but it is not routinely offered.
In summary, adhesive capsulitis is a frustrating condition to have, but there are ways your osteopath can help at all stages. As early stages seem most responsive to acupuncture, it’s worth getting checked out as soon as you can.
If you suspect you have frozen shoulder, get on top of it sooner rather than later. Book in today.