Frozen shoulder
Frozen shoulder is a specific condition that causes stiffness in a shoulder joint. The medical terminology
for this condition is “adhesive capsulitis”, which essentially means that the capsule (a sac that surrounds
& envelops joints) becomes inflamed and stiff.
Who gets them?
It is common in middle-aged men & women (more common in women). Frozen Shoulder is also more common in those suffering from Diabetes or Thyroid problems.
How does it occur?
The cause of the frozen shoulder is unknown. It is more common in patients with diabetes. It can occur after trauma to the shoulder, in this instance the condition is referred to as secondary frozen shoulder.
What are the symptoms?
In the early part of the disease (freezing stage) pain is the predominant symptom. This is followed by pain & stiffness (frozen stage). Over a period of time the pain subsides & stiffness remains the main problem. In the final stage (thawing stage) the stiffness improves. The natural history of the disease may last up to 4 years.
What investigations are required?
X-ray is usually the first investigation required. Ultrasound and MRI Scans are the next step of investigations. The x-ray is usually normal and is used predominately to eliminate other causes of shoulder stiffness.
Treatment
In the early part of the disease process steroid injection & gentle exercises may help. Aggressive physiotherapy is to be avoided. Manipulation under anaesthesia is an effective alternative, however the results can be unpredictable. Predictable dramatic improvement results however from a Hydrodilatation procedure done under a local anaesthetic so you are not put to sleep for this simple procedure, which is very effective in removing the pain and gaining good movements. The other option is keyhole surgery. During this surgery (arthroscopic capsular release) the capsule is released, which results in improvement straight away.