Your shoulders can move more, in more directions, than any other joint in your body – hardly surprising, then, that occasionally something goes wrong. And when it does, not only can they seize up, but they can be extremely painful
Like your hip, your shoulder is a ‘ball and socket’ joint. The ball is at the head of your humerus (the bone in your upper arm) and it sits in a cup formed from bone at the end of your shoulderblade. The end of your collarbone also forms part of the joint, and a ‘cuff’ of muscles called the rotator cuff pull it in all directions. To stabilise the joint, there’s a capsule of tough connective tissue all around it. This arrangement allows maximum range of movement with minimum risk of the shoulder dislocating – although shoulder dislocate more often than other joints because the ‘cup’ is very shallow, to allow more movement.
Who is affected by frozen shoulder?
Frozen shoulder is most common in your 40s-mid 60s, and affects up to one in 20 people at some point. You’re more likely to suffer with it if you’re a woman or if you have other medical conditions like diabetes, heart disease, stroke or overactive thyroid. It’s not the same as arthritis, and although it can happen after a shoulder injury, it usually starts for no apparent reason.
Frozen shoulder is sometimes called ‘adhesive capsulitis’ – in other words, the shoulder capsule gets inflamed (the medical term for any inflammation is ‘-itis’) and scar tissue forms that sticks the shoulder together, reducing movement. Most often, it affects the shoulder you don’t write with. If this happens, you’ll find your shoulder is stiff and you can’t move it as far as you could. It’s often very painful, especially when you move it but also when you lie on it at night or even when you’re resting.
What are the symptoms of frozen shoulder?
The symptoms of frozen shoulder tend to go through phases. The first ‘freezing’ phase is usually most painful, and typically lasts from two to nine months. During this time, stiffness and reduced movement gradually get worse until they reach a peak as the pain wears off. This next ‘frozen’ phase typically lasts four to 12 months, during which you may find that rotating your shoulder is a particular problem. Finally comes the ‘thawing’ phase, when your shoulder gradually returns to normal over the course of one to three years. It’s highly unlikely that you’ll ever get frozen shoulder again in the same shoulder if you’ve had it once.
How can I alleviate symptoms?
Almost every arm movement we take for granted involves the shoulder, so frozen shoulder can interfere with everything from driving to brushing your hair to putting your clothes on. Because the first phase of a frozen shoulder is usually the most painful, pain relief is particularly important in the first few months. Your doctor may offer paracetamol, anti-inflammatory tablets like naproxen or ibuprofen and codeine-containing tablets (or patches that release a steady dose of strong pain relief). Steroid injections into the joint are also an option if the pain is severe, although you’ll need to wait several weeks between injections and can only have up to three because of the risk of damaging your joint.
Physiotherapy can make a huge difference to pain as well as stiffness and range of movement. Your physiotherapist may use a combination of stretching exercises, massage and hot/cold packs. They’ll also advise you on exercises to do at home. While other treatments like TENS machines (which deliver tiny electrical impulses) and acupuncture have been used, they’re not recommended in guidelines because there’s little or no evidence they help.
When is surgery an option?
If you’re still suffering severely, there are several surgical options, all done by an orthopaedic surgeon under anaesthetic. These include manipulating your shoulder to stretch and break down the scar tissue in the capsule, or inserting a tiny telescope into the joint and using radio-waves to break down the scar tissue. You’ll be able to go home the same day although you’ll need physiotherapy afterwards.
With thanks to ‘My Weekly’ magazine where this article was originally published.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.