What Is Frozen Shoulder & Why You Should Care
Frozen Shoulder (or adhesive capsulitis) is a condition characterized by stiffness and pain in the shoulder joint resulting in capsular contracture. The inflamed capsule of the shoulder joint becomes thickened and contracted and this reduces the actual space inside the joint. Seeking treatment from a frozen shoulder specialist is highly recommended.
3 Stages of Frozen Shoulder
This condition is typically described as having three stages:
- Stage one: The “freezing” (painful stage), may last from six weeks to nine months. Slow onset of shoulder pain.
- Stage two: The “frozen” (adhesive stage), slow improvement in pain but the stiffness remains. Stage lasts from four to nine months.
- Stage three: The “thawing” (recovery), when shoulder or upper arm motion slowly returns toward normal. This condition generally lasts from 5 to 26 months.
Why many Singaporeans consult with Dr Chang
Adhesive capsulitis denotes the inflammation of the shoulder capsule leading to the tightening and sticking together of the shoulder capsule.
The following picture shows the inside of a frozen shoulder which appears to be red and inflamed.
Pericapsulitis refers to the inflammation that occurs around the shoulder. Commonly, the stiffness and pain is all around the shoulder during frozen shoulder.
This is due to inflammation of the tissues, muscles and tendons around the joint which contributes to the pathology.
This picture shows the scar tissues in the subacromial space before and after surgical removal.
Signs & Symptoms
Main symptoms of a frozen shoulder are:
- Shoulder pain; usually a dull, aching pain
- Shoulder movement is limited
- Difficulty with activities such as brushing hair, putting on shirts or bras
- Pain when trying to sleep on affected shoulder
The condition starts with gradual onset of pain during shoulder movement. Pain becomes more prominent over time and is usually present when lifting the shoulder overhead.
Frozen Shoulder Causes
Cause of frozen shoulder is often unknown. 2 different types of frozen shoulder:
- Primary – no real known cause, usually associated with diabetic patients.
- Secondary – there is a cause for the onset of the frozen shoulder.
For example, a tear of the rotator cuff tendon causes shoulder pain which makes the sufferer’s shoulder movement difficult and this gradually develops into a full-blown frozen shoulder.
Frozen shoulder most commonly affects patients between the ages of 40 to 60 years old, and it is two times more common in women than in men.
Diabetic patients have five times the risk of developing frozen shoulder compared to non-diabetics. Several systemic conditions such as heart disease, Parkinson’s disease and other endocrine abnormalities such as thyroid problems, can also lead to this condition.
Frozen Shoulder Treatment Options
Frozen shoulder treatment in Singapore involves the following:
- Stretching exercises help to improve range of motions and prevent atrophy of surrounding shoulder muscles.
- Use of oral anti-inflammatory medications.
- Physiotherapy modalities – help to trigger point massage, ultrasound and heat therapy.
- Injection of corticosteroids into the shoulder – allows the inflammation and shoulder pain to reduce.
- Hydrodilatation – injection of saline into the contracted shoulder joint to break the adhesions and increase shoulder volume.
- Manipulation under anaesthesia – allows the surgeon to move the arm to break the adhesions.
The procedure (arthroscopy) is done under anaesthesia. The scar tissue is released (cut) by bringing the shoulder through a full range of motion. After surgery, you may receive pain blocks (shots) so you can do physiotherapy.
Please feel free to contact us to know about the condition from a frozen shoulder specialist in Singapore,