Frozen Shoulder - Symptoms, Causes & Treatment

Sufferers of frozen shoulder experience pain and stiffness in their shoulder joint. In this post, our Nepean physical therapists discuss how this condition can be treated with physiotherapy and other methods. 

What is frozen shoulder?

Also referred to as adhesive capsulitis, frozen shoulder is a self-limiting condition marked by a progressive onset of symptoms, the primary signs being pain, stiffness and a significantly reduced range of motion.

While we have yet to fully understand the onset of frozen shoulder, these symptoms are thought to occur due to progressive inflammation and thickening of the joint capsule in the shoulder.

Having to keep a shoulder still for long periods heightens your risk of developing this condition, which may happen after fracturing an arm or having surgery. Certain populations are at higher risk, including those with diabetes mellitus. 

The symptoms typically start slowly and worsen. It may take 1 to 3 years for symptoms to improve with consistent treatment, usually with range-of-motion exercise, medications and in rare cases, surgery. 

When it comes to treating frozen shoulder, education and communication with a qualified health professional such as a physiotherapist will be critical to managing and recovering from your symptoms. 

What are signs and symptoms of frozen shoulder?

Most people who suffer from frozen shoulder typically notice it developing gradually, in three stages. For some people, pain worsens at night, which can disrupt sleep:

Freezing

Moving the shoulder causes pain, and your ability to move your shoulder becomes limited. This stage may last from 2 to 9 months. 

Frozen

While pain may lessen, stiffness sets in and using your shoulder will likely become more difficult. This stage may last from 4 to 12 months. 

Thawing

The shoulder's ability to move starts to improve. This stage may last from 5 to 24 months. 

What's involved in frozen shoulder diagnosis and treatment?

Diagnosis

During a physical exam, your doctor or healthcare provider may ask you to move your arm in certain ways to assess your range of motion and to check for pain. 

You may also be asked to relax your muscles while the doctor moves your arm (passive range of motion), since frozen shoulder impacts both active and passive range of motion. 

Though this condition can usually be diagnosed from signs and symptoms alone, imaging tests such as X-rays, MRI or ultrasounds can rule out other issues.

Treatment

Most methods for treating frozen shoulder involve managing shoulder pain and preserving as much range of motion in the shoulder as possible. This may take a combinations of medications, therapy and surgery or other procedures. 

While frozen shoulder can be treated with physiotherapy, you'll likely need to attend sessions for 12 to 18 months (note that some people still have symptoms up to 3 years later). 

Treatment may include a combination of education, managing symptoms, monitoring the disease, manual therapy and exercise therapy. 

How can physiotherapy help with shoulder pain?

Physiotherapy for shoulder pain may involve acupuncture and dry needling treatments. During these procedures, one of the trained physiotherapists at our Nepean physiotherapy clinic inserts small, sterile, fine needles through the skin into a specific area of the body. 

Acupuncture has been scientifically known to encourage natural healing, reduce or relieve pain and improve functioning in people with acute or chronic conditions or injuries. 

Dry needling causes the muscle to contract and relax. This releases trigger points in the muscles, increasing flexibility and decreasing pain. 

The team at Nepean Sports Medicine & Physiotherapy Centre looks forward to working with you. Your physiotherapist can develop treatment plan specific to your needs.