Frozen shoulder - choices of treatment

Hi Jana

Frozen shoulder is hell! I had a total of 5 cortisone shots in both shoulders... one in each was injected into the arm (like a vaccine) and they did nothing. The others were injected into the joint from my back and they were wonderful.

My left shoulder released on it's own. One evening the shoulder and bicep started twitching (almost jumping) for about a 1/2 hour. When it stopped I raised my arm up to my ear. There is residual tightness, but no pain.

My right arm (which didn't get as bad) is still mildly painful and I have about 70% range of motion. I am not seeing anyone, just exercising at home.

About a week ago I woke up with a stiff neck - left side. I'm so afraid that the shoulder will start again.

I do have diabetes, but I maintain my blood sugar in recommended ranges. I tried back in August to lower my range in hope of easing the frozen shoulder. It had no effect.

I am still sleeping on the lazy boy.

Here is my story, ten years ago I injured my shoulder playing badminton, felt the pain at the time and then it seemed to ease off later that day, a couple of weeks later I started to get twinges, if I got my movement wrong I felt like I had been tasered. It certainly made me sit down quickly to recover my wits.This got worse and worse over the next year so I went to my gp who thankfully specialised in frozen shoulder, he gave me a cortisone injection, which relieved the symptoms somewhat but not totally. I then had another cortisone injection 3 months later, followed by 6 weekly sessions of physio. All sorted and after a short time no pain and full range of movements back. It may well have been going into the thaw anyway as other commenters have pointed out but I will never know. In April of last year I started to get the odd twinge in the other shoulder and for months I tried to ignore it, hoping it would go away eventually, it did not! By October I felt like I was being tasered 20 times a day, couldn't dress easily, drive, sleep all the usual culprits! I made an appointment to see a shoulder specialist, had xrays and ultrasound scan. Result, nothing going on in my neck but a rotator cuff tear and frozen shoulder (unlucky to get both ailments at the same time apparently) consultant said that they have no idea why these happen sometimes (it certainly wasn't a sports injury this time). I was left in a position where it was steadily getting worse and there was no other option other than to have surgery. To the person who has commented saying leave it, it will get better on its own, not true, a rotator cuff tear does not mend itself! Also I think its fair to comment that pain from frozen shoulder varies from person to person, some are inconvenienced by it but some are in agony with it every day and waiting it out is a very difficult choice. I am 5 weeks post op and am still in considerable pain (just different pain to being tasered) which ever option I chose was going to be extremely painful it would appear. To top it all my body and medication really don't like each other. While tramadol did wonders for the pain it upset my digestive system so much I had to come off it! The really strong anti-inflamotories also affected me in similar ways (I tested that theory as believe me I need something to relieve the pain!) I was given tablets to protect my gut - no use against either tablets I found........so here I am, in tremendous pain (physio would be a joke - it would fell me, Ive tried!) I am seeing a physio currently who so far has done acupuncture and ultrasound treatment, so its a waiting game where some days I could just sit and sob but I have to be optimistic and hope this pain will ease off some time soon. Incidentally I have a high pain threshold so Im not being a wuus. My problems were not suddenly going to rectify themselves, this was my only option. So I come at this from two angles, as you can see from the beginning of my thread, first time round I waited it out till the thaw, second time not an option. Your pain will tell you if you need to do something about it.

I woke up four days ago unable to move my arm. I've been doing exercises daily with hopes of a "quick" recovery. However after reading everyone's replies, I'm wondering if I should press for the MUA surgery earlier as that seems to work for a good portion of others? I'm trying to diligent about doing exercises on my unaffected arm so hopefully I don't get FS over there.

Wooferator, your at the beginning of this and that is the time to see a physio about it and hopefully nip it in the bud before it gets any worse, most of us have gone for the op purely because there is no other option! Go seek help but no consultant worth his/her salt would recommend an op at your stage, it most definitely isn't the easy option if you read all the posts!

Hi

I started having shoulder problems about 12 months ago. Tried physio with no effect. After 6 months saw a shoulder surgeon who (after MRI, ultrasound & xray) diagnosed impingement syndrome. I had a sub acromial release in October. When I came round surgeon said he had also done a capsular release as I had a 'spectacular' frozen shoulder which had presumably been masked by the impingement problems (I have seen the arthroscope pictures and they are all totally red from the inflammation). Diligently followed all the physios advise & exercises and up to about 5 or 6 weeks all went really well with movement to side almost back to normal and could get arms to meet over head. Unfortunately since then movement has become really restricted again and It's just been confirmed by surgeon that shoulder has re-frozen. Fortunately although there is pain at the end of the range apart from that it's tolerable. The one thing that REALLY helps is swimming. I don't use the frozen shoulder to propel myself at all but just letting it 'bob about' really seems to help - probably because all the supporting muscles, tendons etc get a rest. So I try to spend about 40 mins per day in the water.

I'm having a steroid injection on Monday to see if that helps. Apart from that it's then either another arthroscopic capsular release or leave it & see.

As I'm a fanatical tennis player I'm not sure I can wait years to see how it goes but having one operation & no progress puts me off having it again. However I have already lost a huge amount of muscle from the arm & shoulder so worry that if I leave it another year plus I'll never get that back.

I'm not convinced by the pushing into the pain theory of some physios. I stopped this about 2 weeks ago and my overall pain levels have dropped and I don't see any adverse effect on range of movement - sometimes I think the body just needs a rest.

I am a woman just 50+ so I wonder if there is a hormonal link.

I do have other shoulder & arm pains but I suspect that this is because everything is working abnormally to get round the restriction - using a mouse & keyboard to type seem particularly aggravating so all done left handed now.

I had to get the impingement sorted as the tendon was very inflamed & scuffed.

Hi Sportsmum123,

You're story sounds a lot like my experience. I too had arthroscopic capsular release surgery a little over two months ago. Physical therapy went great for the first two to three weeks. I did everything I was told also. After that, it became increasingly harder to do the excersizes. My therapist told me that I had a severe case of tendinitis. He has slowly had me quit doing most all excersizes but the overhead ones, that I have been able to do until the last few days. My arm is extremely painful from the tendonitis when I do almost any excersizes. The pain continues on for days and does not stop. I'm afraid my shoulder is freezing up again but I cannot live with the pain the stretching excersizes cause.

I see my ortho doc again on Friday. I think I know what he is going to say. I think he will say that I can repeat the surgery. I'm definitely not going to do that again anytime soon. It didn't work the last time for me, why would it now? I feel that I need to rest my arm to let the tendonitis heal. Then I will try physical therapy again. Doing the therapy with this tendonitis isn't working so I need to try something different. I've excersized this arm a continuously since I got this and it hasn't helped. I need to try something different.

I feel |'ve been relatively lucky in that both times my shoulder has frozen it's been pretty painless (only knowing it's frozen from lack of range of movement) and so I've been far more concerned about tendon damage which is what caused the original pain and knowing it was already inflamed and scuffed I didn't want to irritate it further so as soon as the exercises started hurting I stopped them. Maybe it's caused the frozen shoulder to come back quicker or to a greater extent than it would otherwise (who knows) but at least the tendon pain is minimal.

I really believe that swimming (without actively using damaged arm at all) is a huge help. I can get to my full range of movement under water without having to use muscles/tendons at all (just letting buoyancy do its stuff) so it doesn't aggravate them at all whilst still keeping as much range of movement as there is.

The frozen shoulder will go one way or another (time or operation) but I think a badly damaged tendon is more likely to give really long term problems and already having had a decompression I'm not sure what alternatives there are left.

Hi all. It sounds as though all our experiences are slightly different even though we all agree that this condition is hell! I know how hard it is to keep things moving but having undergone this with both shoulders I have come to some conclusions:

1) You can't stop it from happening - I started physiotherapy quickly with the second one but it still progressed to being totally frozen and supremely painful

2) Cortisone may help - it did with my first FS and I felt some relief instantly. With the second one I didn't notice any difference and my physio said that cortisone damages the joint so best not to have them if it can be avoided

3) There is no quick fix, you have to wait it out to some extent - but keeping it moving (in spite of discomfort) is helpful in the long run.

4) Only opt for surgery or manipulation once the shoulder has reached the frozen stage, intervening too early doesn't seem to see good results.

5) Nobody knows why some of us get this condition and in all likelihood if you have it once you will have it again. Middle aged and menopausal women are particularly prone to it.

I know that none of this seems encouraging. All I can add is that the manipulation under anaesthetic worked for me and I would have it again even though the recovery is tough. I have been well now for over a year having had my MUA in June 2012 but I feel that if I stopped doing things like pilates I wouldn't be doing myself any favours.

Finally, I don't think that following exercises alone is particularly helpful. All you seem to get on the NHS is advice rather than real hands-on pulling and pushing. I was lucky enough to get an old fashioned physio on the NHS with my first FS and after the MUA I was fortunate to get the same physical attention at a private clinic but paid for on the NHS. They also gave me a pulley which hangs over a door and which can be used to gently lift the arm to stretch the capsule without straining other tendons/ligaments. I recommend this as the best form of stretching.

Hope that helps and I wish Sportsmum, Jana and Wooferator the best of luck. You have my sympathy.

Hi Judyb,

Thank you for your insight. I have come to agree that the shoulder needs to be in the frozen stage before having the manipulation done. I saw a second doctor who told me that patients that don't have a lot of adhesions (my doctor told me that I had only a moderate amount) don't do as well with the MAU as patients that do. My problem has been a lot of inflammation that nothing seems to get rid of.

From what I've read, it seems the inflammation dies down a lot in the frozen stage. I believe the horrible pain comes from inflammation, not the adhesions. If I do get the MAU done again, it will be after the really painful stage is over. I've had this since June and again from what I've read, the first phase of this usually lasts from 3 to 9 months. I'm in the eighth. I just hope that having the surgery done in October does not set me back on progressing to the frozen stage within 9 months from June.

By the way, I am in America and don't have any other health problems. Maybe hormones do play a role in this. I'm 57.

I too wish everyone with this Luck in finding the best path for themselves.

Hi Jana. I hope you are somewhere warm in America and not in the snowy east! If you have access to a warm pool - or better still a jacuzzi or warm spa - try doing gentle exercises in the water. It would help to keep your arm stretched without aggravating the tendonitis. I also suffered from that - and still do sometimes so I'm careful. I think it's because we get used to moving in ways we aren't meant to because the shoulder is frozen, also the muscle wasting as a result of the FS means the tendons, particularly in the elbow, have to work harder. All my opinion but, like you, I suffered with my whole arm, the collar bone area and my neck and clavicle area too. I had my MUA in the ninth month of the FS but at that time I was still getting that agonising bloom of pain with even the slightest jolt of my shoulder so I hadn't reached the stage where it was already getting better.

If you have a good physiotherapist I would ask their advice. The doctors are very keen to intervene but mine barely looked at my shoulder let alone touched it... apart from on the operating table. My physio could tell the situation by feeling and moving things. I had a lot of faith in them both times and they really helped me.

Good luck

I am in sunny Arizona. High today is 70 degrees. (-: I don't know how people can handle that freezing cold! I feel sorry for them. We have extreme heat in the summer, but we have a pool and air conditioning so it's not bad. The pools too cold to swim in now. I don't have a membership to a place with a heated pool. My doctor doesn't do a thing with my arm either. I believe my physical therapist knows more about what's going on with me than the doc does too. For now, I'm just going to take it easy with the stretching excersizes and not go back for physical therapy until this tendonitis settles down some. Each time I go for PT, it takes four days before my arm settles down and I can actually do ANYTHING. I think my body is trying to tell me to slow down and for once I'm going to listen and see if that helps. I don't know if my shoulder is freezing up again for sure or if it's the tendonitis keeping me from doing more. I just know that I can't take the extreme pain that comes from the therapists stretching it. Funny thing is, it's not so painful at the time he stretches it out,it's that night and the next few days that are he'll. Thanks for sharing your experience.

I will keep my fingers crossed and hope that the resting does the trick and you finally start to recover. All the best.

Hi - I had one frozen shoulder followed swiftly by another - other arm. I went through dreadful pain with the first one, getting relief eventually from NAT (Niall Asher) therapy. This however, took 3 months. Knowing how painful the left arm had been, I asked my physio about other options. She told me about Hydrodilitation - a procedure carried out by a radio therapist at the hospital. I went to see the shoulder specialist first and the following week had the procedure and I am COMPLETELY CURED!! I can't recommend this procedure enough - it is far more successful than a cortisone injection as it lasts. Within 2 days the pain had gone and I had 75% movement in my arm. After a couple of weeks I could fully raise my arm and was back in the gym doing Body Pump. Have a google about the treatment, but basically it's an injection of fluid and painkiller into the arm, followed by the application of intense pressure. It takes around 10 minutes in total and only hurts a little - 10 mins of pain in far better than months of feeling sick with the arm pain and all those sleepless nights. Please ask your doctor about it - it is available on the NHS.

Hi all. I was diagnosed with a frozen shoulder last september and have suffered extreme pain with it the majority of the time. I have finally got an appointment through for hydrodilation at the end of the month followed by physio sessions. Christine T52 has obviously had sucess with this treatment but it seems there are not many others who have had this offered to them. My consultant did not give me much information on the actual proceedure and shrugged off my questions regarding pain and possible problems. Just wondered if there was anyone else had this proceedure recently. Thanks

Hydrodilitation is a fairly new technique, fortunately my shoulder specialist is pro this procedure - it is true that not all GPs know about it. Mine had only just had a talk from the shoulder specialist about the benefits. Personally I would persist with your doctor as you are well within your rights to insist on being referred to a shoulder specialist - FS is so debilitating and you shouldn't have to suffer. I had my treatment at Kingston Hospital, Surrey