Frozen shoulder is a condition characterised by pain, stiffness and loss of range of movement in the shoulder joint. It is also known as Adhesive Capsulitis.
The joint and its ligaments and tendons are enclosed in a capsule which also helps to keep in the oil which the joint is bathed in and known as synovial fluid. The capsule becomes inflamed, thickens with scar tissue and shrinks back.
Adhesive Capsulitis has a slow onset developing gradually over a period. Pain is the first noticeable symptom on all movements of the shoulder causing the sufferer to guard against the discomfort by holding the arm still.
After many weeks (unfortunately sometimes months) the pain will begin to decrease however the shoulder will now be exceedingly difficult to move, this is the frozen phase.
The causes of Frozen Shoulder can be a bit baffling as for a large percentage of patients there does not appear to be an obvious cause. It can occur secondary to another condition such as a stroke or a mastectomy or on recovery of a broken shoulder or arm which has had to be immobilised for a long time.
Diagnosis is made with a clinical examination and an x ray. A frozen shoulder is not expected to show up on x ray but is worth doing to establish whether the shoulder is also suffering from arthritis.
The patient may be prescribed anti-inflammatories to help control the pain so that they can begin to move the arm and are usually referred for physiotherapy. Recovery from a frozen shoulder is unfortunately very slow and can take up to 2 years or more for a full recovery. The doctor or physiotherapist may suggest a cortisone injection which in most cases will help speed up the recovery.
Physiotherapy treatment involves mobilisation and passive stretching of the scapula and shoulder joints. Elastic band, rhythmical pendular swinging and auto assisted pulley exercises are taught so the patient can continue them at home. Electrotherapy modalities that aim to reduce pain and improve function may be used by the physiotherapist such as Ultrasound, Low Level Laser, Short Wave Diathermy, TENS, or Pulsed Electromagnetic Field Therapy.
In the treatment of frozen shoulder rarely is only one used and the Physio’s choice of modality may change according to the phase of recovery and the response of the patient.
Tracey Evans
The Physiotherapy Centre
+34 609 353 805
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