Shoulder

Frozen Shoulder

Frozen shoulder, also known as Adhesive Capsulitis, is a condition that results in pain, stiffness, and loss of motion in the shoulder joint. The exact cause is not well understood, but it is often associated with inflammation and fibrosis of the joint capsule. This condition can cause gradual progression of symptoms and may take 18-24 months to resolve, often with an improvement in function over time. Women are more commonly affected, and it typically occurs in people aged 40-60 years.

Phases of Frozen Shoulder

Frozen shoulder typically progresses through three stages:

  • Freezing Stage: During this phase, patients experience a gradual onset of pain, which worsens and leads to a loss of shoulder range of motion. This stage lasts 6-9 months.
  • Frozen Stage: In this stage, painful symptoms may decrease, but stiffness persists, making daily activities challenging. This phase typically lasts 4-6 months.
  • Thawing Stage: During this stage, shoulder motion gradually improves, and strength and mobility begin to return. This phase can last from 6 months to 2 years for full recovery.

Symptoms of Frozen Shoulder

The main symptom of frozen shoulder is pain, which typically presents as a dull, aching sensation. The pain is generally:

  • Worse during the early stages, especially with movement of the arm.
  • Felt around the outer shoulder and sometimes the upper arm.
  • Accompanied by stiffness and limited range of motion, particularly in activities that require lifting the arm or reaching behind the back.

Causes of Frozen Shoulder

Frozen shoulder can affect anyone, but certain conditions and characteristics increase the risk:

  • Recent shoulder immobilisation (due to injury or surgery)
  • Trauma (e.g., after an arm fracture or surgery)
  • Chronic conditions: Diabetes, thyroid disease, or certain autoimmune conditions like rheumatoid arthritis.
  • Previous history of frozen shoulder in the opposite shoulder.

It is important to note that while recurrence in the same shoulder is rare, many people with frozen shoulder may develop the condition in the other shoulder over time.


Diagnosis of Frozen Shoulder

Frozen shoulder is typically diagnosed through a detailed medical consultation and physical examination. The physician will assess the shoulder's range of motion and check for tenderness or swelling. X-rays, MRI, and ultrasound scans may be used to rule out other conditions that could be causing similar symptoms, such as rotator cuff injuries or arthritis.


Treatment Options for Frozen Shoulder

The treatment for frozen shoulder is individualised, depending on the stage of the condition and the severity of symptoms. Most cases resolve over time, but treatment is focused on pain relief, improving range of motion, and enhancing shoulder strength.

Non-Operative Treatment

  • Pain Management: The initial focus of treatment is to relieve pain. Over-the-counter medications like paracetamol and NSAIDs (e.g., ibuprofen) can help manage pain and inflammation. Injections of local anaesthetics and corticosteroids into the shoulder joint may be used to alleviate pain, particularly in the early stages of the condition.
  • Physiotherapy: Once pain decreases, physical therapy is crucial for regaining range of motion and strength. Stretching exercises and manual therapy are often beneficial, although it can be challenging to perform these in the early stages when pain is significant.
  • Hydrodilatation: In cases where physiotherapy alone is not effective, hydrodilatation may be recommended. This technique involves injecting saline and corticosteroids under pressure into the shoulder joint to help stretch the joint capsule and reduce inflammation.

Surgical Treatment

If non-surgical methods fail to provide relief, surgical intervention may be considered. The goal of surgery is to release the stiffened joint capsule and restore movement.

  • Manipulation Under Anaesthesia: In this procedure, the shoulder is forced to move under anaesthesia, stretching and tearing the tight capsule and scar tissue to increase the shoulder's range of motion.
  • Shoulder Arthroscopy: This minimally invasive procedure involves making small incisions in the shoulder and using arthroscopic tools to cut and release the tight portions of the joint capsule.

Post-Surgical Recovery

After surgery, physical therapy is essential to restore shoulder movement and strength. The recovery process will vary depending on the surgical approach and individual factors but generally includes:

  • Rest and Immobilisation: Following surgery, the shoulder may need to be immobilised for a short period.
  • Gradual Rehabilitation: A structured rehabilitation program will help restore full function, including stretching, strengthening, and range-of-motion exercises.

Why Choose Dr. Ryan du Sart?

Dr. Ryan du Sart is a highly trained orthopaedic surgeon with extensive experience in diagnosing and treating shoulder conditions, including frozen shoulder. He uses the latest techniques to ensure that each treatment plan is tailored to meet the specific needs of each patient, offering a path to improved function and reduced pain.


Book a Consultation

If you are suffering from shoulder pain, stiffness, or suspect frozen shoulder, schedule a consultation with Dr. Ryan du Sart today. Early diagnosis and intervention can significantly improve outcomes and speed up recovery.

Phone: (08) 9779 9767
Email: admin@ryandusart.com.au

Clinic Locations:

6 Higgins Street, South Bunbury, WA 6230

20 Prince Street, Busselton, WA 6280


References:

  1. Choi, J., & Lee, Y. (2018). "Frozen Shoulder: Etiology, Diagnosis, and Treatment." Journal of Shoulder and Elbow Surgery, 27(5), 907-913.
  2. Kumar, V., & Gohil, S. (2017). "Outcomes of Non-operative Management of Frozen Shoulder: A Review of Evidence." Journal of Orthopaedic Surgery and Research, 12(1), 17-22.