Frozen Shoulder also known as Adhesive Capsulitis is a musculoskeletal condition affecting range of movement and resulting in pain in the shoulder joint for long periods of time (generally 9 months to 2 years in duration).

This condition can occur as a result of immobilisation, trauma or spontaneously for no apparent reason and it is for this reason that its prevention is most difficult. What we do now is that there are several conditions that have a higher prevalence for frozen shoulder, including diabetes and female between 40-65 young.

It presents firstly as an insidious onset of pain that progressively worsens and a gradual decrease in movement in all directions.  People have sharp pain with end range movement and pain at night. Often people have trouble with overhead activities, dressing and reaching behind the back. Frozen shoulder may however mimic other conditions of the shoulder in its early stage, such as rotator cuff dysfunctions, subacromial impingement/bursitis and osteoarthritis.

Frozen shoulder presents as 3 phases:

  1. Freezing/painful: gradual onset of pain at rest and sharp pain at end range movements and night pain
  2. Frozen/ stiffening: pain remains and shoulder loses range of movement before pain starts to subside
  3. Thawing/ resolution: range of movement starts to improve

This is a self-limiting disease meaning it will get better by itself. There are a few strategies often employed to break these adhesions (hydrodilatation, manipulation under anaesthetic and operative capsular release) but despite their application, many people return to a “frozen” state some months later. Recovery times range between 6 months to several years.

Physiotherapy treatment is beneficial for patients with frozen shoulder. The treatment depends on the phase the patient is in and their particular symptoms and functional ability. A physiotherapist can diagnose and explain the condition, provide pain relief and maintain and/or improve range of movement depending on stage.

Article By: Lachlan Oberg

References:

  1. Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med. 2008;1(3-4):180-9.
  2. Adhesive Capsulitis. (2019, February 4). Physiopedia, Retrieved March 6, 2019 from https://www.physio-pedia.com/index.php?title=Adhesive_Capsulitis&oldid=204318.