Frozen Shoulder (Adhesive Capsulitis)
What is Frozen Shoulder?
Frozen Shoulder, also known as adhesive capsulitis, is a shoulder condition which most commonly affects females aged 45-65 years old. It affects approximately 2% of the population and 10-20% of those with diabetes.
It is characterized by the inflammation and thickening of the capsule of the shoulder joint leading to shoulder pain and loss of movement. It generally resolves between 12-24 months but is quite case-dependent and may resolve quicker or take longer.
Frozen shoulder can be quite a limiting shoulder condition, making tasks in your daily life more difficult to complete.
This image shows a normal shoulder joint on the left and a frozen shoulder joint with an inflamed/thickened joint capsule on the right.
The Stages of Frozen Shoulder
STAGE 1 – INITIAL STAGE (up to 3 months)
- In this stage you could experience sharp pain at end ranges of motion, achy pain at rest, sleep disturbances and minimal range of movement changes. As the shoulder starts to progress to the next stage, you may notice an early loss of external rotation range of motion.
STAGE 2 – FREEZING STAGE (3-9 months)
- This is known as the painful and freezing stage. You will likely notice a gradual loss of range of motion in all directions due to pain. The shoulder joint capsule starts to become affected in this stage and pain is often worse at night and is especially painful when trying to lie on the affected side (often the primary reason to seek help).
STAGE 3 - FROZEN STAGE (9-15 months)
- Increasing pain, stiffness and associated decrease in shoulder range of motion. Eventually the pain starts to plateau and usually begins to decrease.
STAGE 4 – THAWING STAGE
- Pain begins to decrease and the shoulder begins to regain some movement. The shoulder may remain stiff for some time but continues to improve.
What can a physio do to help?
A physio can help design a program with the aim to maintain your level of function. This could include:
- Pain Management strategies
Physiotherapists can also help use manual therapy such as gentle mobilisations around the shoulder, massage and/or dry needling to maintain your shoulder range and stiffness throughout the progression of this condition. In the stages 2 and 3, a cortisone injection may also be recommended.
Although this condition has quite a lengthy clinical course, many patients reports minimal to no shoulder issues at the 12-18 month mark after the shoulder has ‘thawed’.
What can you do about it?
- Wearing loose clothing if dressing is difficult
- Supporting your arm with pillows in bed to reduce pain
- Cold or heat therapy (with the advice of a physio) to reduce pain
- Limiting activities which cause the shoulder to be excessively painful
- See a physiotherapist for further clinical input
If you have a shoulder that is stiff and sore, give our reception team a call on 6281 2499 to book in for a Free Initial Assessment and a physiotherapy consultation and we can start you on your road to recovery!
Written by Matt Gregory (B.Hsc, M. Physiotherapy) and Jess Garlick (B.HSc, M. Physiotherapy Practice)