Frozen Shoulder

The signs and symptoms of a frozen shoulder usually begin slowly, and progressively get worse. Symptoms that may indicate you have or or at risk of developing a frozen shoulder are:

• Pain or stiffness in your shoulder that doesn’t go away

• Pain that often wakes you in the night

• Severe pain when moving your arm at the shoulder, especially with sudden movement

In most cases, a frozen shoulder happens spontaneously, without a cause. It’s not fully understood what causes this to happen, but it’s likely due to your genetic makeup. In some cases, a frozen shoulder can be triggered by an injury to the shoulder joint or shoulder surgery. The condition is also associated with other shoulder problems such as bursitis or tendon injury.

Frozen shoulder most commonly affects those aged 40 to 60 years old, and women are affected slightly more often than men. The condition is also more common in those with systemic health conditions including diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease and Parkinson’s disease.

Frozen shoulder is a common benign condition most often seen in women in the perimenopausal period between the ages of 45 and 55. Having said that, as yet, no link has been found between this condition and the change in hormones seen at this time in life. There is a strong genetic component, as certain people are more prone to developing this condition, and will usually experience in both shoulders at some point in their life. A frozen shoulder gene has recently been identified.

Frozen shoulder gradually builds up over weeks or months with a restriction in movement. This often goes un-noticed by the patient initially as other parts of the shoulder girdle move more to compensate for the stiffness that effects the ball and socket joint. At some point function will start to be effected with typical symptoms being waking night discomfort and sudden movement pain.

These days frozen shoulder can usually be successfully treated without surgery. Usually a special injection into the shoulder joint called “hydrodistension” combined with a “capsular stretching” physiotherapy program is adequate to successfully treat 95% of frozen shoulder. A few do eventually require a keyhole procedure called an “arthroscopic arthrolysis” to surgically remove the scar tissue. These resistant cases are usually in patients with diabetes.

At OneWelbeck, one of our team of orthopaedic consultants will be able to diagnose a frozen shoulder by asking questions about your symptoms and doing a physical examination. In some cases, your consultant will arrange for you to have an X-ray, MRI or ultrasound scan to confirm their diagnosis and also eliminate any other problems that may be affecting the joint.

In most cases, a frozen shoulder can be successfully treated with a combination of different therapies. At your consultation, your consultant will discuss your treatment options and recommend the best next steps.

Treatment options for a frozen shoulder include:

• Injection therapy to break down scar tissue and stretch the connective tissues

• Physiotherapy to stretch out the shoulder and re-establish movement

• Surgery to remove the scar tissue around the joint