Jonathan Wride – Specialist Physiotherapist based at Skelian Clinic in Cheltenham talks about Frozen Shoulders.
What is a Frozen Shoulder?
One of the most common reasons patients get referred to me is for a ‘frozen shoulder’. The diagnosis ‘frozen shoulder’ can often be mistakenly used as a way to describe a painful and stiff shoulder. Many people also refer to frozen shoulders as ‘adhesive capsulitis’, which is a different term for the same condition.
However to accurately diagnose you need to rule out some other conditions that mimic frozen shoulders.
Have you got a frozen shoulder?
The first step is to rule out any other common causes of shoulder pain these conditions include:
- Rotator Cuff Tears
- Calcific Tendinitis
These conditions can be ruled out with a simple ultrasound scan of the shoulder. Once these conditions are ruled out it is also important to look at any common risk factors, including:
- Diabetes (significantly increased risk of developing (frozen shoulders)
- Gender (females more likely to suffer frozen shoulders than men)
- Age (typically aged 50 years +/- 5 years
- Menopause/Hormonal Changes – increases risk of developing frozen shoulder
- Trauma – frozen shoulders can also commonly be triggered by trauma, this is termed a secondary frozen shoulder.
The final piece of the puzzle is to examine your symptoms. A frozen shoulder will typically cause:
- Severe radiating pain down the side of the arm often down to the elbow
- Significant night pain which keeps you awake
- Loss of movement making tasks such as putting on coats very difficult
- A progressive worsening in pain.
So you have gone through all of the above and it sounds like you have a frozen shoulder. The bad news is that most frozen shoulders take 12-18 months to resolve. The good news is that if you get it treated this recovery period can be dramatically shortened.
The treatment depends on what stage your frozen shoulder is at:
Stage 1: within the first 12 weeks – typically very painful, particularly at night and a progressive worsening of shoulder movements.
Stage 2: Typically after 4-8 months most frozen shoulders are no longer very painful but instead just very stiff.
Stage 3: Anywhere between 8-12 months most frozen shoulders start to loosen as movements start to gradually improve.
Jonny’s top recommended treatments:
- If you have had symptoms for less than 12 weeks (stage 1) then the most important treatment is a cortisone injection into the shoulder joint. This will settle the capsule inflammation with over 80% of patients achieving pain relief within 7-10 days. Unlike most steroid injections this is not just going to mask the pain but provide a powerful anti-inflammatory effect, which stops the frozen shoulder worsening.
- If you are over 4-6 months into a frozen (stage 2) and your pain is not too severe but your movements are reduced then shockwave therapy is a great option to speed recovery. Shockwave therapy helps reduce pain and scarring within the shoulder capsule and significantly improves shoulder movements within 4-8 weeks for 75% of patients.
- After a short course of shockwave therapy, it is very important to start some simple home stretches for the shoulder to loosen the tight areas. This will need to be repeated daily for 12 weeks.
Following the above advice and getting the shoulder diagnosed earlier rather than later can cut your recovery dramatically, with most people returning to normal within 3 months.
At Skelian in Cheltenham, we offer the highest standards of physiotherapy care. Jonathan Wride is a specialist physio and independent prescriber based in Cheltenham who provides a variety of treatments. Regarding services relating to the shoulder, we offer both diagnostic ultrasound and ultrasound-guided injections.
So if you are concerned about your shoulder pain give us a call or send the clinic an email firstname.lastname@example.org
Call Skelian Chiropractic Clinic on 01242 254000