Five things you need to know about ‘frozen shoulder’

‘Frozen shoulder’ is a debilitating condition where your shoulder becomes painful and stiff. But how does this condition come about and what can be done to treat it? What are the tell-tale signs that you may have frozen shoulder? And what else do you need to know about this little-known condition? Dr James Sarkodieh, Consultant Radiologist at The Holly, takes a closer look.

‘A common, complex problem’

Also known as adhesive capsulitis, frozen shoulder is a common, complex problem that affects many individuals. It is caused when the capsule of the shoulder joint gets inflamed and then becomes thickened and tight. This restricts the movement of the ‘ball and socket joint’ causing pain and stiffness.

You can get frozen shoulder in just one shoulder or both.

The symptoms that indicate you may have frozen shoulder

The major symptoms of frozen shoulder are pain and loss of motion. You will feel an ache or stiffness that will affect all shoulder movements – from raising your arms to a gentle stretch. This differs from other shoulder conditions such as rotator cuff tendinopathy in which the symptoms are typically produced by trying to raise your arm above the head.

Diagnosis of frozen shoulder

If you think you may have frozen shoulder you should first see your GP or physiotherapist. They will consider your medical history and ask how your symptoms affect your daily activities.

You don’t necessarily need to have a scan or imaging test in order to be diagnosed with frozen shoulder. Often, an experienced healthcare practitioner can make the diagnosis following an examination. Nevertheless, you may be sent for an imaging test to exclude some other causes of shoulder stiffness.

Causes and risk factors – what you need to be aware of

The exact cause of frozen shoulder is unknown but is generally thought to be related to an extended period of arm inactivity, for example when you are recovering from an injury that requires you to keep your arm in a sling.

You’re more likely to get frozen shoulder if you’re aged between 40 and 60, and women are slightly more prone to getting it than men. Other risk factors include previous injury to the shoulder area, being diabetic and having arthritis in the neck (c-spine).

A wide range of treatment options

Frozen shoulder symptoms can go away without treatment – but this can take up to three or four years and for many people is not a realistic option.

There are a number of treatment options to consider. These range from over-the-counter painkillers such as paracetamol or ibuprofen, to physiotherapy to improve the function and movement of your frozen shoulder

In my experience hydrodilatation is the most effective non-surgical treatment. This is where a doctor uses X-rays or ultrasound to guide an injection of fluid directly into the shoulder. The fluid fills the shoulder joint to stretch the capsule and free up the joint. It immediately relieves pain and, when followed by targeted exercise, is effective in re-establishing good shoulder range of motion and function.

Surgery can be helpful when all conservative treatment fails.

About Dr James Sarkodieh

Dr James Sarkodieh has clinics at The Holly Private Hospital. To book an appointment call 020 8936 1202 or email diagnostics@theholly.com