What is frozen shoulder?
Typically the joint is stiff and initially painful, often starting without an apparent cause. The loose bag (capsule) around the shoulder joint becomes inflamed. The bag then appears to tighten or shrink. This tightening combined with the pain restricts the movement.
How common is it?
It is most common in people between the ages of 40 and 70 years and has been estimated to affect at least one person in 50 every year.
About 10% of people may develop frozen shoulder in the other shoulder within 5–7 years of the first one. However it tends to resolve more quickly than the first. Although it is widespread, it is a difficult condition to treat.
What tests may be done?
The main way we diagnose the problem with your shoulder is from what you tell us and from our examination. Sometimes an X ray will be done to check there are no bone changes in your shoulder joint.
What are your treatment options?
There is no one agreed treatment option that has been shown to work. Ultimately the shoulder appears to go through the three phases described and no treatment has altered this pattern. The passage of time is the main treatment!
During the painful phase the emphasis is on pain-relief.
Therefore pain-killing tablets and anti-inflammatory tablets may be prescribed.
You can also try using heat, such as a hot water bottle, or cold (ice packs).
Injections into the joint may also be offered if the pain continues.
Physiotherapy at this stage is directed at painrelief (heat, cold and other pain relieving modalities such as electrotherapy).
Forcing the joint to move can make it more painful and is best not pursued.
You can try using a TENS machine (transcutaneous nerve stimulation) which some people find helpful or try alternative therapies such as acupuncture. Once stiffness is more of a problem than pain, physiotherapy is indicated. You will be shown specific exercises to try and get the ball and socket moving. Some of these are shown at the end of this leaflet. In addition, the therapist may move the joint for you, trying to regain the normal glides and rolling of the joint. These are known as joint mobilisations. Muscle based movement techniques may also be used. If movement is not changing with these measures, physiotherapy will be discontinued, although it is appropriate to continue with the suggested exercises to try and maintain the movement that you have. Hopefully, as the recovery phase starts you will find that the movement gradually increases. This, again, can be a useful time to have physiotherapy to help maximise the movement.
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