Frozen shoulder is a painful ailment that causes the shoulder joint to stiffen and become uncomfortable. It primarily affects adults between the ages of 40 and 60 (women are affected more than males) and generally begins without warning. It can happen after shoulder surgery or a fall. Using clinical testing and a diagnostic ultrasound scan, your doctor will be able to diagnose frozen shoulder during your first session. Physiotherapy and conservative treatments such as rest and/or pain medications do not always work for frozen shoulder.
Symptoms
The symptoms of a frozen shoulder are:
- The shoulder is stiff and in a lot of pain.
- The pain is increasing and spreading down the arm.
- Pain wakes you up in the middle of the night.
If this sounds like a problem you’re having, keep reading…
What are some other symptoms of frozen shoulder?
If this does not sound like your pain, there are a number of different conditions that can produce frozen shoulder pain, including:
- sub-acromial bursitis
- calcific tendinopathy
- shoulder impingement
- rotator cuff pain
- osteoarthritis
Anatomy
The glenohumeral (shoulder) joint is formed by the ball-shaped protuberance at the end of the humerus (long bone of the upper arm) and the shallow dish (called the glenoid fossa) on the shoulder blade (scapula). These bones make form the glenohumeral joint, which is a ball and socket joint. This joint can perform all of the movements that the shoulder can. This article will focus on the joint afflicted by adhesive capsulitis (frozen shoulder).
The symptoms of frozen shoulder include extreme discomfort and increasing stiffening of the shoulder joint. The capsule around the joint, in particular, swells and tightens.
It is a relatively prevalent source of shoulder pain, affecting between 2% and 5% of the population. Frozen shoulder has no recognised origin, yet it is clearly a painful and incapacitating syndrome. Frozen shoulder can keep people awake at night, and even basic everyday activities can be severely limited and uncomfortable.
Frozen shoulder can be classified into three stages. Each of these stages might endure for years before resolving, and the duration varies from person to person. These are the stages:
- The first stage is known as the “painful” stage. This period can continue several months, during which the shoulder tightens and gets more painful.
- The second stage is known as the “tough” stage. During this period, the shoulder remains extremely tight, resulting in impaired function.
- The ‘unfreezing’ or ‘thawing’ step is the third stage. The shoulder begins to relax and mobility gets easier throughout the thawing period. It can take months, if not years, for this to be resolved completely.
The Risk Factors involved in the treatment of Frozen Shoulder
Although the mechanism underlying the start of frozen shoulder is unknown, the following conditions have been linked to an increased risk of occurrence:
- Women are more likely than men to develop frozen shoulder.
- Frozen shoulder is most common in people between the ages of 40 and 60.
- Secondary frozen shoulder can be caused by trauma to the shoulder, such as fractures, dislocations, rotator cuff tears, or surgery.
- Diabetes mellitus (type 1 and type 2)
- Over or underactive thyroid
- Cardiovascular disease.
How do you know if you have frozen shoulder or not?
Frozen shoulder normally develops over time, however it can occasionally happen suddenly due to trauma or injury. The most frequent onset, however, is gradual.
Its symptoms include:
- Pain that is difficult to manage with over-the-counter analgesics, ice, and physiotherapy.
- Pain that keeps you awake at night or interferes with your ability to sleep.
- Increased shoulder stiffness that makes it difficult to raise your arm or carry out regular tasks like dressing and undressing
Frozen Shoulder Diagnostics
It is advisable to seek expert care as soon as possible if you feel you have frozen shoulder. A diagnosis of frozen shoulder will be made based on your clinician’s clinical assessment. A formal diagnosis is made after a combination of strength and range of motion testing.
Other diseases that can cause a frozen shoulder must be ruled out. This includes the following:
- Glenohumeral joint osteoarthritis
- Acromioclavicular joint osteoarthritis
- Calcific tendinopathy
- Rotator cuff tendinitis/tendinopathy
- Subacromial bursitis
- Long head of bicep tendinitis/tendinopathy
You may be referred for an x-ray if your physician is still confused about your diagnosis after conducting a clinical assessment. This is done to rule out other shoulder diseases including shoulder osteoarthritis, which might mimic frozen shoulder.
X-ray is the gold standard imaging tool for diagnosing joint disease such osteoarthritis or fractures. Your doctor can recommend a number of blood tests. Other illnesses, such as rheumatoid arthritis-related systemic inflammation, are ruled out through blood testing. These aren’t usually required.
Although x-ray is an effective tool for assessing joint dysfunction, it cannot detect soft tissue enlargement, which is common in this illness. With diagnostic ultrasound imaging, this is plainly obvious.
Frozen Shoulder Treatment
Conservative therapy alone, according to research, has limited efficacy in the painful (initial) stage of frozen shoulder. Physiotherapy for the treatment of frozen shoulder will comprise a gradual stretching exercise regimen, manual treatments to mobilise your shoulder joint, and potentially acupuncture and tape.
Here are some helpful points:
- Change your daily routine and attempt to avoid tasks that make you feel uncomfortable. Breaking down an assignment into smaller, more manageable chunks or taking daily breaks are instances of this.
- Place a pillow under your hurting arm and sleep on the unaffected side if you sleep on your side. Place the pillow under the back of your shoulder and under the aching arm if you’re lying down on your back.
- Begin with a simple arm stretching regimen. Walking your fingers up a wall to stretch the shoulder joint is a nice place to start. It may be easier to stretch the shoulder after a hot shower or bath, or by using a hot water bottle.
- Over-the-counter pain relievers like paracetamol and nonsteroidal anti-inflammatory gels like Voltarol can help. Talk to your pharmacist about the prescription you’ll be taking before starting therapy.
Book your appointment Today! If you require alternate appointment times, please contact us and we will gladly assist you with your reservation.
What to Expect on Your First Visit:
- At Physiotouch Courtice, you will register with our friendly front office staff.
- A comprehensive assessment by a Physiotherapist or other Health Care Provider will take you through a detailed history of your major physical concern, assessment of your range of motion and strength, as well as a variety of special tests specific to your injury or dysfunction. These assessment findings are analyzed and used to create a clinical impression. This will help us to better identifying and understanding your problem and formulating an effective treatment plan tailored specifically for your needs and to achieve the realistic goals. This treatment plan could involve a number of things including therapeutic exercises, therapeutic modalities, manual mobilizations, massage, patient and family education, activity modification, home exercise programs, supervised exercise programs and many others.
- There will be some treatments performed the first day to get you started on your path to recovery. However, during the next visits you will get into all aspects of your treatment plan.
- Our staff will help you scheduling your next visits at Physiotouch Courtice as per treatment plan recommended by related Health Care Provider. We offer many convenient appointment times, however, prime times can become busy, so it is best to book ahead as much as possible.
- If you have any questions at any time, please do not hesitate to call. We want to ensure your satisfaction and full recovery.
Before Your First Visit
- You will receive a confirmation email shortly after booking your appointment.
- This email will contain some forms which you can fill out and sign from your device in handy.
- If you have any questions, ask us before signing the form.
- If you are not able to access the forms online, please arrive 15 minutes early for your first appointment so that we can help you with the paperwork.
- Make a list of questions that you want to discuss on your first visit.
- Bring with you if you have any imaging reports (i.e.) X-rays, Ultrasound/MRI (etc.) and doctor’s referral.
- Bring with you a copy of your insurance card and a photo ID.