Frozen shoulder - choices of treatment

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I first noticed the symptoms of FS about 4 months ago - it seemed to come out of the blue for no reason at all. Just as mystifying was what should I do about it - do I go to a physio, GP, acupuncturist, osteopath, chiropractor - or am I better off doing nothing at all?!!

After doing some research, I decided my best course of action would be to go to an osteopath. However, what I would advise other sufferers is to be aware that this can be a very, very long process and can end up costing you a fortune!!

They gave me twice-weekly appointments at the beginning which I didn't mind paying for as I wanted to get myself cured as soon as possible.

The appointments involved gentle manipulation and she would give me exercises to do at home. My arm is gradually getting some small amount of movement back (although my practititioner did say that this was largely due to my hard work at sticking to the exercises) and the pain has diminished (although from what I understand this is part of the disease process and is probably nothing to do with the osteopath!)

In retrospect, I am glad that I sought treatment with an osteopath, but in my naivety I had not realised what a long process it would be and how much it would cost. I am still going to sessions but, at my request, I have staggered the appointments so that they are further apart.

I am now getting pains in the other side and unless I win the lottery, I feel that I couldn't possibly afford to go through it all again!!

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  • Posted

    That sounds awful. I have refused any injections so far - had one in my ankle joint/achilles a few years ago and swore I would never do it again. What 'popped'?Was your joint calcified too?

    Hope you feel better soon. Pain like this is just so exhausting and debilitating. It's hell.

  • Posted

    Ok, it's now 5 days since the theraputic arthogram. I would say it was worth it.. I am virtually pain free. Even when I push the arm in the exercises I don't feel pain.. I just feel the tightness, resistance, the inability to move it beyond the freeze. At this point with my left arm I am happy to wait and let it run its course. My right arm is advancing very slowly. If I use it for any sharp motion it hurts like the devil, but if I just baby it - its good. I stretch it out regularly to the point of the spasms starting and stop. So questions fellow 2nd arm freezers.. What did you do that worked to either slow or stop your 2nd arm from getting as bad as the first???

    Gary... since the arthogram, I can sleep for about 2 hours on the lazy boy again.. as long as I dont turn to my side and since Friday have gotten up to 4 hours in a row from my pillow propped sitting position on the sectional. Life's good for now. I am continuing with massage therapy.. he has to work very tight neck muscles every time... so while I have no idea which is the problem... I leaning towards your theory.

  • Posted

    Hi HeatherL

    Glad to read you've had an improvement. Perhaps a little of both methods, in a situation like yours where both shoulders are affected, has helped. I've never had it in both at same time, so can only imagine the problems. Also, I don't think that if it happens in one shoulder it follows that the other becomes vulnerable as well. That's probably a matter of chance depending on which neck movements cause it in the first place, or what level of degeneration exists in the cervical spine. With these sort of neck problems, the gradual degeneration causes the neck muscles to adjust to each new phase, sometimes adopting various grades of unnatural stiffness and easing, and I think that's what makes the shoulder vulnerable. It's also impossible to predict when or if FS might happen, although I believe that knowing that certain arm movements like reaching behind or stretching out above shoulder height are likely to set it off, it becomes easier to avoid a re-occurance. I think I've managed to keep it at bay for 10 years by just avoiding these triggers, although every so often I'm aware of a niggling vulnerability .

    I'd still say be careful with the exercises because there's no proof they will speed up recovery. It's only natural to want to be a bit aggressive with it, slow recovery is always very frustrating, and we all tend towards something that might be a quick fix. I'd even say that especially after injections to mask the pain, it's more important to be careful, because you won't feel if you are stretching too far. Could give rise to a one step forward, two steps back scenario. Doing nothing won't make it worse.

    If you get to find the upright sleeping helpful....I hope you'll spread the word.

    Gerry

  • Posted

    Hi Heather

    I really feel for you with both shoulders in this condition - awful! I hope the injection helps you get through the pain sufficiently until they improve a bit. In the meantime, I know how it feels to have dreadful tightness across the top of you shoulders and round your neck. I definitely believe that this tension is part of the problem but I'm not certain that it's the original cause. I hope not or I'll be getting FS again!! Lesley mentioned a heat pad and I found it massively beneficial to use a wheat-filled neck cushion warmed in the microwave. It just seems to help those muscles to relax and feel more comfortable. I was also recommended to use a jacuzzi if you are near a hotel or leisure centre with that facility. I wasn't able to visit one regularly but when I did it was lovely. Finally, I sleep with a bead-filled neck cushion like those used on planes. I don't put it round my neck but I used it as a support by hugging it when lying on my side to stop my bad shoulder rolling forward. During my recovery it was indispensible in other ways in bed, e.g. to raise parts of my body to take pressure of the uncomfortable places. It also went everywhere with me, e.g. in the car to support my neck and to help me relax more easily. I'm sure you've tried all these things but just in case I thought I'd share this.

    Good luck and I hope you recover quickly.

    Judy

  • Posted

    Hi All - Just a quick update... I am still very comfortable in the pain department since the arthogram. Although not a pleasant procedure to endure.. the resultant loss of pain is wonderful. Unfortunately I did not get any gain in range of motion then or yet. My left shoulder seems to be following the worst case scenario. The freezing stage went from Feb.- Sept (7 mos.) The frozen stage is continueing since Sept, and i understand this is a 3-12 month stage. I continue to do mild exercing... there is no pain just total restriction, and I believe now that I can only wait for it to run its course (left shoulder). My right shoulder has advanced to the point where bumping something is awful, sharp movement drops you, however I can still raise it to my ear... it hurts.. it causes some bad spasms... but I can do it... I don't do it often.. just a few times a day in hopes on not losing any more range of motion - which seems to be working for me. For those just starting this awful condition, I feel for you... My suggestion is to look for what works for you.. sleeping different, heating pads, massage, etc. I agree with Gerry that pushing it makes it worse.. that is my experience... pain is your body saying STOP! and what I believe now is that we need to listen to out bodies. If like me, the pain takes over your life, then the arthogram is a relatively uninvasive, low risk procedure to consider. Good luck and good sleep to all sufferers.
  • Posted

    Hi everyone, it has been 8 month since my MUA, my last post being back in Oct 2012, time fly.

    As time passes so fast, I actually almost forgotten the pain of frozen should I got back in Mar last year. I happen to pump into the bookmark and get back to this forum and recalling me sharing experience of my FS. Now I can say that those sharp pain that I use to have has completely gone! I should be grateful, though human tend to be forgetful.

    Any way, I do plenty of stretching every morning, and I believe it really help. I start to feel tightness now on my left shoulder, I am determine to continue exercise it and not to let it develop into FS like my right side did. I was told that, FS require 30% treatment 70% training, and prevention is always better than cure.

    I hope many of you here, has recover well like me. And please do a lot self exercise and stretching, it is definitely do good. Cheer !!

  • Posted

    Hi, ive recently gone open surgery to shoulder for a pec tear and had to wear a sling 24/7 for 4 wks unfortunately this has left me with a frozen shoulder i have been in extreme pain, but now the pain is settling as long as i dont try to get my arm past just below shoulder height, its been 3 months since op. However to get back to work i need overhead movement for shoulder so its not ok for me to just live with it, i also have horses and even if they did give me the go ahead to ride now i cant get my arm up to put bridle on without aggrevating it and causing more pain. i cant tie my hair back without cocking my head to one side and resting my elbow on something while i put band on. I go back to see surgeon next week and i wanted advice to best course of action because i think he may advise a capsular release either by keyhole or just manipulation does anyone know of best action to take, thanks.
  • Posted

    Hi Shirley33, I had a capsular release done last June and I can honestly say from my point of view it was the best thing ever, I did not have the time to wait for my shoulder to un-freeze and the pain was so unbearable I could not stand it anymore. The operation was a success, after waking up my arm still felt stiff but the pain had gone, I did have discomfort during physio but every day the more I kept moving my arm the more movement I got back. Within 4-6 weeks i had almost total movement back in the arm and shoulder. Unfortunately for me my other shoulder was also playing up and I have been undergoing physio and injections from June last year and nothing has worked so 2 weeks ago I underwent on my other shoulder a subacromial decompression and so far so good, bit more pain this time but have almost full movement. Good luck with your recovery and your decisions. I feel your pain. Xx
  • Posted

    Thanks summeralex, I have been back to see my surgeon however he doesn't think i need it, he thinks because it is due to the surgery I,ve recent gone thru that it just needs more time to settle and the movement will come back, Ive been back to my physio and he's brutal but does get more stretch in it and i,ve been trying to strengthen up with swimming. I,m not so much in pain now and my sleep is getting more comfortable but i just cant straighten arm up still, I can reach up but by contorting my body and leaning back and my whole shoulder capsule lifts in one go as opposed to sliding thru the joint capsule :-/ so i,m not sure what to think, if his advise is right all will be well, however i,m starting to think this might be the best its gonna get after the surgery ive just had done and i'll just have to learn to adapt and live with it. x

  • Posted

    Hi All... Just thought I'd report in. My left shoulder is still basically pain free.. however.. when raising my arm out to the side it will only go to shoulder height.. when raising it out in front.. I can almost get to my ear.. reaching behind.. almost to a back pocket. No new range of motion, even with the daily exercise regime.

    I had an arthrogram on my right shoulder on Thursday... it was totally different.. it took 45 min on left and only five on the right. The left kind of swam away from the joint and the right blew away. The right was not as awful as the left however the pain is not gone on the right yet. But I can raise it higher out in front.. its early yet. I have quit the massage therapy and it is better without it. Anyone have any advise on getting the range of motion back... the doctor did offer to do another arthrogram on the left, saying that some patients require two procedures.. the waiting list is 8 months - my son got me on a cancellation list last time.

    I tried to find other hospitals that would do this procedure.. NONE!

  • Posted

    I had the manipulation under anaesthetic 3 days ago. I have pretty much full movement again, which is amazing! The shoulder is still painful, but I am taking steroids for another condition, PMR, which helps with the pain. I do feel the need for lots of exercise to keep working on it and to ensure that I keep the movement. I'm going to get back to swimming again. I would recommend the operation. It's worth it to get the movement back in the arm again, and there seems to be a purpose to the physiotherapy now.
  • Posted

    I had this condition for about 6 months before I visited my GP. The arm was virtually clamped to my side, such was the pain and restriction in movement. My GP first tried to get me into a private hospital under NHS Choices but the hospital wouldn't see me as I've had a heart valve replacement and I might die on their premises and mess their stats up. Sometimes private hospitals can be a right pain in the shoulder.

    Anyway, after that delay I got an appointment at an NHS hopsital (that's one that actually allows sick people on the premises). After the scans etc I had an Arthroscopic Capsular Release (keyhole surgery) and manipulation on November 5th of this year. I had these under local anaesthetic and a nerve block. All done as day surgery. The nerve block completely numbs your arm and it feels like it isn't yours. It's the strangest feeling. Anyway, the arm was in a sling for 24 hours and I was prepared for pain. None came.

    I was due to have my first physio appointment but had a bout of norovirus on the day and the hospital, quite rightly, asked me to stay away. I couldn't get an NHS appointment for a couple of weeks so I saw a physiotherapist privately to fill the gap. I had (and still have) 6-8 exercises, that I do a minimum twice a day, to stretch the muscles. My NHS physio has also give me some exercises to start strengthening the shoulder muscles (the fabled rotator cuff muscles).

    It's 7 weeks since the surgery and the movement is greatly improved. I have pretty much 95% range of motion in most directions. Some lag behind others. The external rotation is back, I can pretty much extend the arm overhead until it's level with my ear and there is progress on movement behind the back. That said, I am still limited to how far I can move it through muscle power alone; I can't lift it much past 90 degrees under my own steam but I can "finger walk" up the wall to almost vertial.

    There is some soreness, and even pain sometimes, but nothing like that which I experienced as part of the condition. I put the pain down to the exercises and the fact that I do have some arthritis in the shoulder joint.

    My opinion is that if you are offered the option of a surgical release then consider it. It's not a miracle cure and you will have to work hard to maintain the improvement that you should get. The physiotherapy will be tough at times, but that is going to come however this condition is resolved (surgery, manipulation or naturally) as you will need to stretch the muscles and regain the strength that has been lost.

    My goals are to get back to scuba diving this year and to be able to play with my grandaughter without pain.

    If this tale helps anyone then I'm pleased that I shared it. I'll try to update this with my progress.

    Regards

    Dom

  • Posted

    It's good to see a report on a successful treatment so well explained, even if my own view is that FS is best left alone to self resolve. I wouldn't discount the fact that the treatments might work for some variations of the condition. However, not for all, and seemingly, not for a high percentage of patients. What's right for some might be wrong for others perhaps because they are not yet able to distinguish different types of FS applicable to different age groups and different underlying conditions. Ultimately the patient faces a choice to undergo treatment, or not. Unfortunately there is really no way of knowing the correct choice until the results are experienced, which might take many months. My argument would be that the professional encouragement to undergo treatments needs to be counter balanced with the already accepted view that FS will self resolve eventually, and that patients should also be advised of this important option.

    Still and all, glad to hear your treatments seem to have gotten a result.

    Gerry

  • Posted

    I would agree that any condition that will, in time, resolve itself should really, wherever possible, be left alone. The one caveat I would put around that is that as long as you can do everything that you "need" to do.

    Unfortunately I am a self-employed contractor which means "no work = no income". As my current contract involves travelling, I also needed to be able to drive. As such, I needed to have the issue resolved as soon as I could. This, in addition to the unknown of how long this condition may actually take to reslove itself, lead me to accept the treatment. I did have to consider it carefully and, to be honest, I considered not having the treatment right up until the day before the surgery. I've already had a hip replaced and I have a mechanical aortic valve so I'm no stranger to having to make decisions on surgery. However, the knowledge that a frozen shoulder should, in time, resolve itself does make this a distinctly different decision to my previous surgeries.

    In addition to the above, I had worked hard to shed 6 stone in weight following my heart valve surgery and had become very active in the process. The frozen shoulder virtually put paid to any type of physical exercise; I couldn't even ride a bike. I have put on a stone since the onset of frozen shoulder, despite trying to keep tight control of my diet. I want to get back to the gym and my various leaisure activities in order to shed that weight again.

    I guess what I am trying to say is that you really need to weigh up all sides of the proposed treatment options,including doing nothing. If the condition is painful but is not stopping you from leading an almost normal life (which may be the case for some), then surgery may not be the best option, or certainly should not be rushed into. It's all too easy to grasp at any straw in the first stages of the condition. The (sometimes excrutiating) pain of the initial stage does subside and you are left with the restricted movement and less pain. If you can live with that then I would suggest that you try to do so.

    All you can do is research the treatments and make a decision that appears right for you. Your research will probably bring you to this forum; it did for me.

    I wish anyone who develops this condition the best of luck in beating it. As I said previously, I will try to share my progress.

    Dom

  • Posted

    HeatherL, my frozen shoulder started in June of this year (2013). I found that I could not sleep on either side for very long because it would start to hurt. I also had a really hard time pulling my swimsuit off over my

    head. I saw the doctor and he diagnosed me as having adhesive capsulitis. I inadvertently broke loose the

    adhesions in my right shoulder by making a sudden move reaching from the front of the seat in my car to the back seat. There was a terrible pop that was excruciatingly painful, but from then on, I could move my right

    In every direction. No such luck with my left.

    I went to physical therapy for a few visits and got some excersizes to do at home. I wasn't very diligent in

    doing them then. I still had pretty good range of motion so I did them two or three times a week. By mid

    August It was hurting more and I had a more limited range of motion. The doctor gave me a cortisone shot

    and told me to do a few excersizes. The shot did nothing. I did excersizes that I found on the internet

    diligently twice a day for the next five weeks. My shoulder was really killing me night and day by this time and I couldn't do most of the excersizes anymore. Saw the doc again and he gave me another cortisone shot and said if this didn't work, I might want to think about arthroscopic capsular release with MAU. The shot didn't

    work. By mid October, I agreed to have the surgery. He did it Oct. 29.

    The first two weeks after the surgery were great. The physical therapy was painful, but I was getting better.

    Then I started to go downhill. I believe what happened was the cortisone shot that I was given in surgery finally worked. After two weeks it started wearing off and I started having a lot of pain. Now my PT says that I

    have a severe case of tendinitis and I need to take it easy on the few excersizes that he has me doing in

    order to let the inflammation die down. The doctor prescribed a medril pack (prednisone) which did not help at all. I'm maybe a little bit better than before the surgery, but not much. You sound like you have a lot of inflammation also. I hope the cortisone shots work better for you than me. Please keep me posted on how you're

    doing. This is hell and it helps to hear others story. Take care.

    me to d

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