By Laurie Melrose-Doering, Osteopath & Applied Kinesiologist
Frozen shoulder (adhesive capsulitis) is a shoulder condition characterized by restricted movement, stiffness, and pain. It is slightly more common in women and usually affects people over the age of 50.
Frozen shoulder does eventually resolve without treatment, but it takes a long time.
We do not know what causes frozen shoulder – it is classified as an idiopathic condition.
We do know, however, that there is fibrosis and contracture of the joint capsule of the gleno-humeral joint.
The gleno-humeral is the ball-in-socket joint of the shoulder and is responsible for most of the shoulder movement.
Frozen shoulder is often falsely self-diagnosed because many people assume they have frozen shoulder if they struggle moving their arm.
True frozen shoulder, though, is only present when the joint capsule of the ball-in-socket joint shortens. Otherwise, pain and limited range of movement can be due to a myriad of other shoulder problems. These include rotator cuff injuries and subacromial impingement, biceps tendinopathy, shoulder osteoarthritis, rheumatoid arthritis, and polymyalgia rheumatica.
It is important to note that frozen shoulder is limited to the shoulder. If you simultaneously develop knee or neck pain, you may be presenting with something else. In any case, if you are unsure, you should see a specialist – for example your GP or osteopath.
Frozen shoulder typically comes in three stages – the painful stage, freezing stage, and the thawing stage.
Painful stage:
Freezing stage:
Thawing stage:
The loss of movement in frozen shoulder is usually very debilitating and can interfere with sleeping, combing hair, cycling, and driving.
Only 3% of adults will have frozen shoulder at some point in their lives.
You are likelier to get frozen shoulder if you:
Even if you have no treatment at all, there is a very high chance your shoulder will get back to normal. But different treatment approaches are likely to speed up recovery. Here are some options:
Shoulder exercises are safe and easy to do and can be recommended by a physiotherapist or osteopath. The aim is to maintain as much shoulder movement as possible.
As mentioned above, physios and osteopaths can prescribe shoulder exercises.
In addition to this, physios may try TENS machines, and osteopaths will address the wider area. This includes the neck, the other shoulder joints and muscles, and the nerve supply to the shoulder.
Both physios and osteopaths may also use ultrasound therapy.
Paracetamol can dampen the pain during the painful and freezing stages. Taking too much paracetamol can compromise the liver.
Anti-inflammatory painkillers, such as ibuprofen, diclofenac and naproxen, can dampen the pain. However, anti-inflammatory painkillers come with side effects, such as irritating the stomach lining and the kidneys. Therefore, I do not recommend the use of NSAIDs, even over-the-counter, if it can be avoided.
In any case, you should not take anti-inflammatories for more than a week or two. If you are, speak to your GP or pharmacist.
A steroid injection into the shoulder can provide pain relief for a few weeks. The remission is short-lived, however, and steroid injections come with risks.
The procedure can damage tendons, introduce infection to the shoulder, and cause bleeding.
Sometimes, none of the treatments work and the shoulder does not recover after a considerable amount of time. In such cases, you may consider the following operations.
Because of the risk of making matters worse, surgery for frozen shoulder should be avoided until all else fails.
Frozen shoulder usually resolves on its own but can take a long time. With treatment, you should expect faster improvement.
Often, the best approach is to do shoulder exercises, keeping the shoulder as mobile as possible, and seeing a specialist, ideally an osteopath.
An osteopath will try to mobilise the shoulder within the non-painful range in order maintain and increase mobility. This will ensure no new adhesions are formed that will compromise the shoulder.
Also, osteopaths are best-placed to treat the wider area, including the neck, nerve supply, and other shoulder joints. This will ensure shoulder movement is not impeded by other nearby dysfunctions.
In addition to this, some osteopaths have access to ultrasound therapy which can help frozen shoulder. I would recommend checking this with your osteopath because not all practices do.
At the Aston Clinic London in New Malden we have an ultrasound machine.
So, if you believe you may have a frozen shoulder, please get in touch.
To book a session with one of our herbalists, click here. Alternatively, you can contact us at 020 8942 3148 to learn how our treatments can benefit you.
Aston Clinic London is a third-generation complementary health clinic located in New Malden, serving Kingston, Norbiton, Wimbledon, Raynes Park, Surbiton, Chessington, Worcester Park, Sutton, Richmond, and other areas of southwest London and Surrey.
By Laurie Melrose-Doering, Osteopath & Applied Kinesiologist
