Frozen Shoulder Injuries
We are all familiar with the term Frozen Shoulder, but in reality a true frozen shoulder, or to give it its’ correct name, Adhesive Capsulitis, is not as common as one might think. Reluctance to lift one’s arm because of pain (often due to inflamed shoulder tendons – see subacromial impingement) is frequently confused with an inability to lift the arm because of stiffness. Pain is a common feature in the early phase of an evolving frozen shoulder, but as the discomfort subsides, individuals are left with a stiff shoulder and it is often at this stage when the pain has lessened but movements are not improving and physiotherapy is not helping that patients will seek out Huw’s advice.
Although a frozen shoulder may develop following relatively minor trauma to the arm such as a fall or stretching injury to the arm, we still have much to learn as to how and why it occurs in some people, but not in others. Frozen shoulder is more common in women and in middle age. Diabetics and those with thyroid disease appear more prone to develop the condition. A secondary frozen shoulder can occur following immobilisation of the arm (as for example after an operation or injury).
In terms of investigation it is important to exclude other causes of pain and stiffness such as arthritis and an ordinary xray is very useful. Scans are only indicated if there has been an injury to the shoulder and it is thought necessary to exclude a tendon tear.
Injections and physiotherapy form the mainstay of treatment for many, but when the condition proves resistant to such treatment a small arthroscopic (“keyhole”) procedure to release the thickened tissue within the shoulder that causes stiffness is typically successful in restoring movement. Such surgery can usually be performed on a day case basis.