Frozen Shoulder Pain

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Shoulder Pain

Published: 27 November 2015

I treat frozen shoulders daily in my physiotherapy practice - and thankfully if you follow a few tips it can normally be resolved with great success.

Frozen Shoulder

What is a frozen shoulder and the best way to manage it.

A frozen shoulder is an inflammatory condition which arises in the shoulder joint. That means the muscles and soft tissues get inflamed around the shoulder - it primarily affects the capsule of the gleno-humeral joint.

The symptoms of a frozen shoulder is that you will tend to experience a sharp and deep pain in one or the other shoulder, and you will find that your range of motion in that shoulder is limited, severely in some cases. We will look at this condition in a little bit of more detail in this article, but in summary - the affliction will generally take from six months to three years to resolve without medical assistance. However, physiotherapy and other medical intervention will help speed up recovery considerably so you should really be looking at treatment options if you have can.

It should also be noted that I frequently see people at my practice who have been wrongly diagnosed with frozen shoulder. As a result of this incorrect diagnosis, directed treatments are not effective and these people often end up suffering with long-term pain and stiffness due to this wrong diagnosis. So if you are getting some of these symptoms and think it could be a frozen shoulder, seek both a doctor and physiotherapist’s opinion before you accept the diagnosis you have been given. Furthermore, seek out the experts who specialise in shoulder pain to be sure!

Frozen Shoulder Pain.

Frozen shoulder pain is deep and sharp all at once. It usually presents around the shoulder area itself as well as radiating down the outside of your arm as far as your elbow. In the early stages, it is usually only experienced on movement of your arm, but in the painful stage it can be associated with severe pain while resting also. Many patients report their arm to be useless and are unable to lie on the affected side for months without appropriate treatment.

Other shoulder injuries can present with similar pain patterns as frozen shoulder, so an accurate diagnosis from the outset is very important. This will influence your response to frozen shoulder treatment positively as well as speeding up your recovery time.

Do not ignore the early signs of a stiff or painful shoulder, as early intervention is the key to your treatment. The causes of this shoulder pain are unclear, however I usually find there is a physical and emotional component to their cause, and treatments need to address both aspects from the outset. I combine pain medication, physiotherapy, shoulder exercises and craniosacral therapy in my management of frozen shoulder patients with great success.

The Stages of Frozen Shoulder.

It is generally agreed that a frozen shoulder has three stages. Remember they can last from 12-24 months without treatments!

• The first stage is the acutely painful stage. It is also referred to as the “freezing” stage. This stage usually persists from 1-4 months. The pain during this stage gradually worsens which then causes the joint to gradually loose movement.

• The second stage is the “frozen” stage. During this stage the pain does not get any worse and in many cases gets a little better. However, the stiffness continues and intensifies. This stage can last for 2-10 months depending on the client, cause and the interventions undertaken.

• The third phase is the “thawing” phase, also known as the recovery phase. This can last weeks or months again depending on the client, cause and the treatments undertaken.

No two people are the same with frozen shoulder that is for sure! However, knowing the cause is a great bonus as removing the cause of a problem is always a medical priority.

Where Physiotherapy can help in the treatment of a Frozen Shoulder

Although physiotherapy and exercises can be very effective at all stages of frozen shoulder - their use is most effective in this third stage. Exercises and mobilisations at this stage appear to help return the client to normal quite quickly. However, diligence to your exercise programme is required!

Although there are many opinions on the value of different forms of frozen shoulder treatment - I find manual conservative intervention very effective if performed both correctly and at the correct time.

Medication and steroid injections are sometimes required in conjunction with manual treatment, if the pain is too severe to mobilise your joint.

Your first stop should be a physiotherapist and a good doctor.