Frozen!

This condition is estimated to affect 1 in 20 people in the UK at some point in their life, usually when aged between 40 and 60. It will affect more women than men.

It is more common in people who have Diabetes or who have problems with their Thyroid. It has “Frozen” in its title but has nothing to do with winter. It’s a “Frozen Shoulder” and it can also be called an “Adhesive Capsulitis.”

Our shoulder joint is a ball and socket joint which is surrounded by sleeve called the capsule. This tissue has to be very flexible to allow us to reach forwards, backwards or out sideways. For some reason, and it is not known exactly why, the capsule becomes inflamed and then thickened. This causes the classic three stages of a Frozen Shoulder.

1. “FREEZING” - For no particular reason the shoulder and upper arm will start to become sore. It can be particularly painful to lie on at night. You will notice pain on movements, especially on rotating your shoulder, which we have to do to put a jacket on. This inflammatory stage can last from 2 – 9 months.

2. “FROZEN” - This can last from 4 – 12 months and is where the shoulder becomes less painful but movements become more restricted as the capsule thickens.

3. “THAWING” - The pain fades and movement begins to return which can take 4 months to several years.

These stages are not always easy to distinguish as they can merge into each other. The good news is that a frozen shoulder will almost always get better on its own, but it may take 2 years or more to do so. There are treatments that can help, however, as yet there is no overall consensus on which treatment option is the best way to manage this condition but research is continuing.

The aim of treatment in stage 1 is to relieve pain. This is where your GP or local Pharmacist can help with medication. It is sensible in the early stages to try to avoid the movements which cause most pain but do keep the shoulder moving. If tablets are not controlling pain, and particularly if you are having a lot of shoulder pain at night, your GP may offer an injection of Corticosteroids into the shoulder to help reduce pain and inflammation.

During stage 2 and stage 3, physiotherapy can be most useful. Treatment can include mobilisation techniques, active exercises and stretches to help movement return plus exercises to help regain muscle strength. In fact, recent evidence suggests that strengthening exercises are the most beneficial.

A Frozen shoulder is not an easy condition to live with as a tight painful shoulder can be very debilitating. Remember that it will get better and that there are positive things that you can do at home to help. If you have any questions about what to do for the best, just ask.

The health column is contributed by McNaughton Physiogrange, Edinburgh www.physiogrange.co.uk