Frozen Shoulder

Frozen shoulder

Frozen shoulder is a common shoulder problem. It is caused by the inflammation of the soft tissue around the shoulder joint. Degenerative changes and overuse of the shoulder may cause capsulitis. In some cases, it may happen in patient with decrease movement of shoulder due to various causes (e.g. in people who suffered from stroke or received operation around or near the shoulder joint). It is common in adults aged over 50, more commonly seen in females.

Symptoms

Inflammation stage (6wk to 9mo) – In the early stage, there will be progressive shoulder pain, typically becomes more obvious at night time and may affect sleep. Patients may also feel pain when sleeping on the affected side.

Frozen stage (4-6mo) – the shoulder pain will persist, and patient will experience some limitation in shoulder joint movement.

Thawing stage (6mo to 2yrs) – shoulder pain will decrease but resulting in stiffness in shoulder. Daily activities like putting on clothes, overhead activities, bathing may become difficult.

Treatment

Application of hot pad can relieve the shoulder pain.

Physiotherapy (e.g. Ultrasound, shockwave, muscle stretching exercise) can relieve shoulder pain

Painkillers (e.g. NSAID) are commonly used, but they should be used only after doctor’s advice and with care.

Lifestyle modification and home exercise are also important for treatment of the adhesive capsulitis.

For patients who are not responsive to the conservative treatment, minimal invasive surgery with shoulder arthroscopy for capsular release and manipulation under anaesthesia (MUA) is recommended.