Frozen shoulder is characterised by stiffness and restriction of movement leading to a high degree of shoulder joint immobilisation (passive and active movements).
In most cases there is also some localised pain that can also cause secondary pain in the neck and trapezius muscle.
Patients are generally unable to raise their arm above 45 degrees and often any movement that involves external shoulder rotation inhibits pain.
Pain at night is often more severe, and a secondary side effect of frozen shoulder is insomnia.
It is most common over the age of 40 and more prevalent in woman.
Symptoms can often last from 5 months to 3 years, but healing time can be reduced with appropriate therapy, stretching and preventative techniques.
Causes
It is most commonly caused by thickening and contraction of the joint capsule – the connective tissue around the bony structures of the shoulder joint. There can also be a lack of synovial fluid in the joint
Can be caused by injury, however, it may also be a secondary symptom of thyroid, metabolic disease, stroke and auto-immune disease. Higher incidence in smokers. In many cases, there is no recognisable cause.
In Eastern medicine – deficient cases, there is a lack of nourishment (Ying Qi), leading to tendon/muscular weakness. In excess cases, wind/cold/damp/injury penetrates the shoulder joint causing local Qi/Blood stagnation in the channels (often Colon/Small Intestine channels). Can also include Gall Bladder, Lung, Triple Heater and Pericardium channels.
Treatment
Aims to reduce pain, increase recovery time, increase range of movement and prevent worsening of symptoms.
Western medicine treatment aims to reduce pain and inflammation with anti-inflammatory drugs, and if particularly severe, steroid injections are used. Chronic painful issues are sometimes treated with surgery.
The most effective method of recovery is to continue a full range of movement within the joint to prevent further joint stiffness and muscle loss/weakness. Therefore, physical therapy generally involves range-of-motion exercises. Functional exercises should include moving the diseased shoulder in abduction, adduction, internal rotation and external rotation – morning and night.
Other therapies that can be effective are massage, acupuncture, herbal linaments and stretching. Common acupuncture points include SI9,10, LI4, 11, 14, 15.
Signs/Symptoms