Frozen Shoulder

Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, medically known as adhesive capsulitis, is a condition characterized by pain and stiffness in the shoulder joint. It’s significantly more common in women, accounting for 70% of cases, primarily affecting those between 40 and 70 years old. There’s some thought that the hormonal changes associated with menopause and their impact on connective tissue might play a role in its development.

The three stages of frozen shoulder

Frozen shoulder progresses through three distinct stages:

1. Freezing/Painful Phase: This initial stage brings increasing pain and gradual loss of motion. It can last anywhere from 2 to 9 months.
2. Frozen/Stiffening Phase: During this phase, pain may lessen, but the shoulder’s stiffness becomes more pronounced, significantly limiting movement. This stage typically begins around 4 months and can persist for up to 12 months.
3. Thawing/Resolution Phase: In this final stage, your shoulder’s range of motion slowly starts to improve. This can be a lengthy process, lasting anywhere from 5 to 24 months

 The severity and duration of symptoms are highly individual. However, effective treatment can potentially shorten the recovery period and reduce the level of disability, even if complete resolution still takes an extended time.

Treatment approaches for frozen shoulder

Physiotherapy is often the cornerstone of treatment for frozen shoulder. However, several other treatments can be beneficial at different stages of the condition:

1. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): These medications are frequently used during the initial, painful “freezing” phase to help manage pain.
2. Corticosteroid injections: Especially effective in the early stages, these injections reduce pain and inflammation, making it easier for physiotherapy to improve the shoulder’s range of movement.
3. Hydrodilatation/shoulder distension arthrogram: This more invasive procedure involves injecting sterile saline fluid (often mixed with a steroid) into the joint. The goal is to expand the joint capsule, which can help improve movement.