About Frozen Shoulder and Frozen Shoulder Treatment

Are you frustrated with your Frozen Shoulder that is not getting better? Are you experiencing painful to your Shoulder, Stiffness to your Shoulder, or unable to lift your hand up? You are in the right place! We will definately be able to help with our innovative and non-invasive (non-surgical) form of treatment. Get your Shoulder check today. Call us at (65) 6471 2744 or Email to: info@boneclinic.com.sg to schedule for an appointment

Definition of frozen shoulder:

Frozen shoulder, or adhesive capsulitis, is a condition that causes restriction of motion in the shoulder joint. The cause of a frozen shoulder is not well understood, but it often occurs for no known reason. Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue.

What causes frozen shoulder?

Most often, frozen shoulder occurs with no associated injury or discernible cause. There are patients who develop a frozen shoulder after a traumatic injury to the shoulder, but this is not the usual cause. Some risk factors for developing a frozen shoulder include:
  • Age & Gender
    Frozen shoulder most commonly affects patients between the ages of 40 to 60 years old, and it is twice as common in women than in men.
  • Endocrine Disorders
    Patients with diabetes are at particular risk for developing a frozen shoulder. Other endocrine abnormalities, such as thyroid problems, can also lead to this condition.
  • Shoulder Trauma or Surgery
    Patients who sustain a shoulder injury, or undergo surgery on the shoulder can develop a frozen shoulder joint. When injury or surgery is followed by prolonged joint immobilization, the risk of developing a frozen shoulder is highest.
  • Other Systemic Conditions
    Several systemic conditions such as heart disease and Parkinson’s disease have also been associated with an increased risk for developing a frozen shoulder.

What happens with a frozen shoulder?

No one really understands why some people develop a frozen shoulder. For some reason, the shoulder joint becomes stiff and scarred. The shoulder joint is a ball and socket joint. The ball is the top of the arm bone (the humeral head), and the socket is part of the shoulder blade (the glenoid). Surrounding this ball-and-socket joint is a capsule of tissue that envelops the joint.
Normally, the shoulder joint allows more motion than any other joint in the body. When a patient develops a frozen shoulder, the capsule that surrounds the shoulder joint becomes contracted. The patients form bands of scar tissue called adhesions. The contraction of the capsule and the formation of the adhesions cause the frozen shoulder to become stiff and cause movement to become painful.
A frozen shoulder causes a typical set of symptoms that can be identified by your doctor. The most important finding is restricted movement. Other shoulder conditions can cause difficulty with movement of the shoulder, such as a rotator cuff tear; therefore it is important to have an examiner familiar with this condition for a proper diagnosis.

What are the typical symptoms of frozen shoulder?

  • Shoulder pain; usually a dull, aching pain
  • Limited movement of the shoulder
  • Difficulty with activities such as brushing hair, putting on shirts/bras
  • Pain when trying to sleep on the affected shoulder

What are the stages of frozen shoulder?

  • Painful/Freezing Stage
    This is the most painful stage of a frozen shoulder. Motion is restricted, but the shoulder is not as stiff as the frozen stage. This painful stage typically lasts 6-12 weeks.
  • Frozen Stage
    During the frozen stage, the pain usually eases up, but the stiffness worsens. The frozen stage can last 4-6 months.
  • Thawing Stage
    The thawing stage is gradual, and motion steadily improves over a lengthy period of time. The thawing stage can last more than a year.

What test are needed to diagnose frozen shoulder?

Most often, a frozen shoulder can be diagnosed on examination, and no special tests are needed. An x-ray is usually obtained to ensure the shoulder joint appears normal, and there is not evidence of traumatic injury or arthritic changes to the joint. An MRI is sometimes performed if the diagnosis is in question, but this test is better at looking for other problems, rather than looking for frozen shoulder. If an MRI is done, it is best performed with an injection of contrast fluid into the shoulder joint prior to the MRI. This will help show if the capsule of the shoulder is scarred down, as would be expected in patients with a frozen shoulder.

What are the treatment options available for frozen shoulder?

Frozen shoulder treatment primarily consists of pain relief and physical therapy. Most patients find relief with these simple steps, although the entire treatment process can take several months or longer.
  • Exercises and Stretching
    Stretching exercises for frozen shoulder serves two functions:

    • First, to increase the motion in the joint
    • Second, to minimize the loss of muscle on the affected arm (muscle atrophy)
    The importance of stretching and exercises cannot be overemphasized as these are the key to successful frozen shoulder treatment. Patients cannot expect to have successful frozen shoulder treatment if they perform exercises only when working with a therapist. These exercises and stretches must be performed several times daily.
  • Moist Heat
    Applications of moist heat to the shoulder can help to loosen the joint and provide relief of pain. Patients can apply moist heat to the shoulder, then perform their stretching exercises–this should be done at least three times daily. Moist heat can be applied by using a hot-soaked washcloth on the joint for 10 minutes before stretching.
  • Physical Therapy
    Physical therapists can help a patient develop a stretching and exercise program, and also incorporate ultrasound, ice, heat, and other modalities into the rehabilitation for frozen shoulder. As said previously, it is important that patients perform their stretches and exercise several times daily–not only when working with the therapist.
  • Anti-inflammatory Medications
    Anti-inflammatory medications have not been shown to significantly alter the course of a frozen shoulder, but these medications can be helpful in offering relief from the painful symptoms.
  • Anti-Inflammatory Injections
    Anti-Inflammatory  injections are also commonly used to decrease the inflammation in the frozen shoulder joint. This can help to decrease pain, and in turn allow for more stretching and physical therapy.

Will i need surgery for frozen shoulder?

If the above treatments do not resolve the frozen shoulder, occasionally a patient will need to have surgery. If this is the case, the surgeon may perform a manipulation under anesthesia. A manipulation is performed with the patient sedated under anesthesia, and the doctor moves the arm to break up adhesions caused by frozen shoulder. There is no actual surgery involved, meaning incisions are not made when a manipulation is performed. Manipulation under Anaesthesia has very good result in treating frozen shoulder to whom that priorly only diagnosed with Frozen Shoulder without other shoulder problem. This procedure is very simple to do and only need 30 minutes to perform. This procedure is usually to be done under daycase. Patient will experience the improvement almost immediately after the procedure.

Alternatively, an arthroscope can be inserted into the joint to cut through adhesions. This procedure is called an arthroscopic capsular release. Surgical capsular release of a frozen shoulder is rarely necessary, but it is extremely useful in cases of frozen shoulder that do not respond to therapy and rehab. If surgery is performed, immediate physical therapy following the capsular release is of utmost importance.

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