The term ‘Frozen Shoulder’ is a term often used to describe a painful and stiff shoulder. Historically this has led to other painful shoulder conditions, such as sub-acromial pain syndrome and calcific tendonitis being wrongly termed a ‘frozen shoulder’. A true frozen shoulder, AKA Adhesive Capsulitis is a specific pathology of the shoulder characterised by a significant reduction in your shoulder movement without a known, existing biomechanical disorder.
The condition tends to effects women more so than men, usually between the ages of 40-60. In fact, in Japan Adhesive Capsulitis is often referred to as ’50-year-old shoulder’. It is also significantly more prevalent among diabetics, with some figures suggesting a pa;tient with diabetes is five times more likely to develop the condition.
Adhesive Capsulitis can be categorised as either primary or secondary. A primary Adhesive Capsulitis will occur with no particular history of trauma or injury, and will lead to a significant reduction in movement at the shoulder and the shoulder blade. The cause of this type of Adhesive Capsulitis is largely unknown but is thought to be an inflammatory response of the joint capsule – a tissue that surrounds the joint – that causes it to become stuck to itself, hence ‘Adhesive’. In contrast, a secondary Adhesive Capsulitis will follow a particular event that preceded the onset of shoulder pain, such as a trauma or surgery to the effected arm.
When to seek help
Adhesive Capsulitis will tend to go through three phases. First is the ‘freezing’ stage, when the shoulder and upper arm tend to become painful and the movement at the joint becomes progressively more restricted. You may notice that you are struggling to reach a high shelf, put a shirt on or reach your back pocket for example. This would be the best time to get some help to diagnose the issue and treat it appropriately.
Following this is the ‘frozen’ stage when the movement stops getting any worse but also does not seem to get any better. Usually, the pain starts to become more manageable at this point. Finally, is the ‘thawing’ stage is when the movement starts to come back and you are able to return to your usual level of function.
Typically, Adhesive Capsulitis can last anywhere from six months to two years. We still do not seem to know exactly what causes it to start or what sets it on the path to recovery. However, the role of Physiotherapy for this condition is vital. Firstly in the diagnosis as once we know what we are dealing with we can ensure that the condition is being treated appropriately. As pain tends to be the main issue in the early stages there are techniques that can be utilised to help in reducing pain, including soft tissue release and acupuncture. Your Physiotherapist will also provide information about the condition and advice and exercises to help maintain the movement that is available and to help manage pain levels.