Do you have frozen shoulder?
The pain and stiffness of frozen shoulder can affect up to 1 in 50 people a year in the UK and is one of the most common shoulder problems. It can make daily tasks such as dressing and driving very difficult and sleeping can become disturbed. Many people don’t realise they have a frozen shoulder and put up with the pain and stiffness instead of seeking treatment and advice.
The shoulder joint (Glenohumeral joint) is comprised of the upper spherical end of the humerus sitting in the shallow socket of the shoulder blade (scapular) creating an unstable ball and socket joint. The joint relies on the support of the flexible, soft tissues around the joint to hold it in place, such as the ligaments, tendons, muscles and capsule. The capsule is a thin layer of ligamentous tissue which surrounds the shoulder joint.
What Happens?
It is the capsule comprising both ligaments and tendons which first inflame, (swells) thicken and contract in frozen shoulder. There are classically 3 stages to frozen shoulder.
Freezing painful stage – it will first become painful and then start to stiffen. Typically the pain will be worse at night lying on that side and mobility will gradually decrease.
Frozen stage – the pain eases but limitation in shoulder movement is still marked, especially rotatory movements such as brushing hair, putting your arm in a sleeve or fastening bra strap. There is often muscle wasting due to lack of use.
Thawing recovering stage – gradually the stiffness and limitation may improve to normal.
Why does it happen?
Frozen shoulder is a condition which is still not fully understood and can occur without trauma or previous shoulder problems but there are certain groups it may occur more frequently with.
It usually occurs in people over 40 years of age
Diabetics have an increased chance of developing frozen shoulder, are more likely to experience worse symptoms and also are more likely to have both shoulders affected.
Post-operative patients, particularly chest or breast surgery.
Elbow and wrist conditions such as RSI or tennis elbow can develop into frozen shoulder after a few months due to an increased demand on the shoulder
Any shoulder trauma or injury may develop into a frozen shoulder so it is vital to seek advice as soon as possible as long periods of immobility can lead to frozen shoulder.
What can be done?
Osteopathic Treatment aims It is important to seek help quickly with shoulder pain or reduced mobility. Without treatment frozen shoulder can last 2-3 years and in few cases several years. Early treatment can dramatically reduce long-term limitation in shoulder mobility. The main aim of treatment is to reduce pain and inflammation, and to maintain the movement of the shoulder while waiting for the condition to pass. An Osteopath will carry out a case history and full physical examination of the shoulder and surrounding joints to help discover the diagnosis. If treatment is appropriate this commonly involves:
Gentle manipulation and articulation to the shoulder which is essential in frozen shoulder as passive movement (where the muscles are relaxed) allows the shoulder to be gently taken into ranges that are normally restricted ensuring better ranges of shoulder movement to be restored when the condition resolves
Acupuncture or dry needling
Soft tissue, stretch and muscle energy to associated muscles to allow more movement, improved muscle health and prevent lasting fibrosis (scar tissue) of the muscles and ligaments
Exercise – It is very important to keep the shoulder mobility and strength but it is wise to get professional advise as certain exercise will feel painful and although this is not always a negative thing, you need to be sure the exercises you are doing are not aggravating the condition.
Medication – Your GP may prescribe a type of anti-inflammatory