This is one of the most painful and frustrating conditions of the shoulder, which is the only joint in the body that can 'freeze up' in this manner.
We don’t know why this happens. We do know that certain conditions like diabetes, thyroid disease, heart disease and high cholesterol may be associated with a frozen shoulder.
Frozen shoulder may also develop after trauma or surgery to the shoulder.
A frozen shoulder develops in four phases:
- Inflammatory – the shoulder becomes painful, seemingly out of the blue. This usually happens between one and three months from the 'trigger' condition or trauma.
- Freezing – The shoulder remains painful and becomes increasingly stiff. Usually after two to nine months.
- Frozen – During this phase the pain lessens, but shoulder is still very stiff. This typically happens after three to nine months.
- Thawing – As the name suggests, the stiffness finally clears up.
It is important to know that frozen shoulders will resolve themselves on their own, even if no treatment is given. This might take two to four years.
Early diagnosis and appropriate treatment can significantly speed up the healing process as well as lessen the pain and discomfort.
Frozen shoulder is identified using a clinical diagnosis. One of the early signs is a loss of external rotation.
Initial treatment is symptomatic: anti-inflammatories and pain medication, as well as cortisone injections into the affected joint once a month for three months running.
Once the pain has subsided, physiotherapy is indicated to treat the stiffness and help regain joint mobility.
In rare cases where the patient is not coping with the stiffness, even after the above treatments, a capsulotomy may be required. This is a keyhole surgery in which the shoulder capsule is released.
After the capsulotomy, early physiotherapy is necessary to maintain the shoulder's range of motion