Frozen Shoulder

Frozen shoulder, also called adhesive capsulitis, occurs when shoulder capsule thickens and becomes tight. Stiff bands of tissue called adhesions develop in the shoulder.

Cause

The causes of frozen shoulder are not fully understood. Associated factors include – Diabetes, hypothyroidism, hyperthyroidism, Parkinson’s disease, cardiac disease and immobilisation for a significant period of time due to surgery or fracture / trauma or injury.

Presentation

Dull or aching pain which is typically worse on movement of the arm and at night. The pain is usually located over the outer shoulder area and also sometimes the upper arm. There is reduced movement of the shoulder often causing significant disability.

Treatment

Frozen shoulder eventually gets better over time, although it may take 2 years to 6 years.

Non operative treatment consists of non-steroidal anti inflammatory drugs (NSAIDS) & physiotherapy. Steroid injection can aide pain and improve physiotherapy compliance.

Operative treatment consists of shoulder arthroscopy and release of the tight tissues around the joint. Most patients have very good outcomes with these procedures.

Recovery

After surgery, physiotherapy is necessary to maintain the motion that was achieved with surgery. Recovery times vary, from 3 weeks to 9 weeks. Commitment to therapy is the most important factor in returning to all the activities you enjoy.

Long-term outcomes after surgery are generally good, with most patients having reduced or no pain and greatly improved range of motion. In some cases, however, the motion does not return completely and a small amount of stiffness remains.

Although uncommon, frozen shoulder can recur, especially if a contributing factor like diabetes is present.

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