Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain, stiffness, and limited range of motion in the shoulder joint. It typically develops gradually, starting with mild discomfort and eventually leading to severe restriction of shoulder movement. People with frozen shoulder often experience pain both during movement and at rest, particularly at night when lying on the affected side.
While the exact cause of frozen shoulder isn’t always clear, it often occurs after a period of immobility due to injury, surgery, or an underlying medical condition such as diabetes. The condition can be debilitating, making it difficult to perform everyday tasks like reaching, lifting, or even getting dressed.
Symptoms of Frozen Shoulder
Frozen shoulder usually progresses through three stages:
- Freezing Stage: This is the initial stage, where pain gradually increases, and shoulder movement becomes more difficult. The shoulder may feel stiff, and any attempt to move it results in sharp pain. This phase can last anywhere from six weeks to nine months.
- Frozen Stage: In this stage, the pain may begin to subside, but the stiffness in the shoulder worsens. The shoulder becomes harder to move, and the range of motion is severely limited. This phase can last from four to six months.
- Thawing Stage: During this final stage, the shoulder gradually begins to regain movement. Pain continues to decrease, and flexibility slowly returns. This phase can last anywhere from six months to two years.
Symptoms may vary from person to person, but the most common complaints include:
- Shoulder pain that worsens at night, especially when lying on the affected side
- Stiffness and limited range of motion, making it difficult to lift the arm overhead or reach behind the back
- Radiating pain that may extend from the shoulder down into the arm or even the hand
- Difficulty with everyday activities such as dressing, bathing, or reaching for objects
Frozen shoulder can be a frustrating and painful condition, but the good news is that it can be effectively treated with physiotherapy.
What Causes Frozen Shoulder?
While the exact cause of frozen shoulder is not always identifiable, certain risk factors can increase the likelihood of developing the condition. These include:
- Prolonged immobility: Shoulder injuries, such as rotator cuff tears or fractures, or recovery from surgery can lead to immobilization of the joint, increasing the risk of frozen shoulder.
- Medical conditions: People with conditions like diabetes, heart disease, thyroid disorders, and Parkinson’s disease are more prone to developing frozen shoulder.
- Age and gender: Frozen shoulder is most common in individuals between the ages of 40 and 60, and it affects more women than men.
Physiotherapy Treatment for Frozen Shoulder
The key to treating frozen shoulder is restoring movement, relieving pain, and reducing stiffness. A comprehensive physiotherapy plan can significantly improve shoulder mobility and reduce pain over time. Treatment options include a variety of hands-on techniques, exercises, and complementary therapies to help patients regain full function of the shoulder.
Here are some of the most effective physiotherapy treatments for frozen shoulder:
1. Hands-on Mobilisation
One of the most important components of physiotherapy for frozen shoulder is joint mobilisation. This technique involves gentle movements of the shoulder joint to help improve its range of motion. Mobilisation helps loosen the capsule of the joint, which becomes thickened and stiff during frozen shoulder. By starting to gently move the shoulder, physiotherapists can begin to restore mobility in the early stages of treatment.
2. Stretching Exercises
Stretching the joint capsule and surrounding muscles is crucial for improving flexibility. Specific stretches target the shoulder joint and help loosen the tight structures that limit movement. As the joint becomes more flexible, patients will notice increased ease in performing daily tasks. Passive and active stretches, often guided by a physiotherapist, will be introduced gradually and adjusted according to the patient’s progress.
3. Soft Tissue Release
During frozen shoulder, the muscles around the shoulder, particularly the rotator cuff and shoulder blade (scapula), become tight and strained due to compensating for the lack of movement in the joint. Soft tissue release techniquestarget these tight muscles, helping to reduce tension and improve blood flow to the affected areas. Releasing the muscles early in the treatment can relieve pressure on the shoulder joint and aid in restoring movement.
4. Acupuncture for Pain Relief
Acupuncture is a proven technique to assist with muscle release and pain management. It helps to desensitise irritated nerves and reduce the overall pain experienced in the shoulder. Acupuncture can be particularly effective in the early stages of frozen shoulder, helping patients to tolerate the discomfort associated with stretching and mobilisation exercises.
5. Heat Therapy
Heat therapy is another effective way to manage pain and increase mobility. By applying heat to the affected shoulder, blood flow to the area is increased, which promotes healing and reduces stiffness. Heat can be applied through various methods, including hot packs or ultrasound therapy, and is often combined with other physiotherapy techniques for maximum effectiveness.
6. Personalised Exercise Program
A personalised exercise program is an essential part of the rehabilitation process for frozen shoulder. Physiotherapists will develop a home exercise routine tailored to the patient’s specific needs and the stage of their frozen shoulder. Exercises will be progressed gradually as the shoulder becomes more mobile and pain subsides. These exercises may include:
- Range of motion exercises to maintain and gradually improve mobility
- Strengthening exercises for the shoulder muscles to support the joint and prevent further stiffness
- Posture correction exercises to reduce strain on the shoulder during daily activities
By adhering to a well-structured exercise program, patients can accelerate their recovery and prevent future shoulder issues.
The Importance of Early Intervention
The earlier frozen shoulder is treated, the better the outcome. Physiotherapy not only helps manage pain but also restores the shoulder’s range of motion and prevents long-term stiffness. Without intervention, frozen shoulder can take several years to resolve on its own, but with appropriate physiotherapy, recovery time can be significantly reduced.
When to Seek Help for Frozen Shoulder
If you’re experiencing shoulder pain, stiffness, or difficulty moving your arm, it’s essential to seek professional help. Frozen shoulder can worsen over time, so early intervention is key to a faster recovery. Physiotherapy is an effective, non-invasive treatment that can help restore your shoulder’s function and relieve pain.
For further information on how I can support you in treating frozen shoulder, or to book an appointment, please get in touch at 07813 912 313 or email tors@stoneystrettonphysiotherapy.co.uk.