Painful and stiff frozen shoulder is a condition where a shoulder becomes very painful and stiff. Movements of the shoulder gets reduced, sometimes completely ‘frozen’. It is thought to be due to scar-like tissue formed in the shoulder capsule. Symptoms usually subside in 2 to 3 years without any treatment.

Symptoms in 3 phases:

1. Phase one – the ‘freezing’, painful phase.

• This typically lasts 2-9 months. The first symptom is usually pain. Stiffness and limitation in movement then also gradually build up. The pain is typically worse at night, and when lying on the affected side.

2. Phase two – the ‘frozen’, stiff phase.

• This typically lasts 4-12 months. Pain gradually eases but stiffness and limitation in movement remain and can get worse. All movements of the shoulder are affected but the movement most severely affected is usually rotation of the arm outwards. The muscles around the shoulder may waste a bit as they are not used

3. Phase three – the ‘thawing’, recovery phase.

•  This typically lasts 5-24 months. The stiffness gradually goes and movement gradually returns to normal, or near normal.
• Symptoms often interfere with everyday tasks such as driving, dressing, or sleeping. Even scratching your back, or putting your hand in a rear pocket may become impossible. Work may be affected in some cases.There is great variation in the severity and length of symptoms. Untreated, on average the symptoms last 2-3 years in total before going. In some cases it is much less than this. In a minority of cases, symptoms last for several years.

Who gets frozen shoulder?

Frozen shoulder affects about 1 in 50 adults at some stage in their life. It most commonly occurs in people aged between 40 and 60. It is more common in people who have diabetes. Either shoulder can be affected but most commonly, it is the non-dominant shoulder.

Treatment options:

The aim of treatment is to ease pain and stiffness, and to keep the range of shoulder movement as good as possible whilst waiting for the condition to clear.

 Anti-inflammatory painkillers

Shoulder exercises:

These are commonly advised. The aim is to keep the shoulder from ‘stiffening up’, and to keep movement as full as possible.

Surgery

An operation is sometimes considered if other treatments do not help. Techniques that are used include:

• Manipulation. This is a procedure where the shoulder is moved around by the surgeon while you are under under anaesthetic.
• Arthroscopic capsular release. This is a relatively small operation done as ‘keyhole’ surgery. It is often done as a day-case procedure. In this procedure the tight capsule of the joint is released with a special probe. One recent research study showed that this procedure gave about an 8 in 10 chance of greatly improving symptoms. Because of the encouraging results of this research study, it may become a more popular treatment.