Treating Frozen Shoulder With Physiotherapy

Did you know that one in every 20 people is estimated to experience frozen shoulder? Did you know that frozen shoulder is also known as 'Adhesive Capsulities'? And, that the effects of frozen shoulder can last up to seven years?

According to the American Academy of Orthopaedic Surgeons, frozen shoulder affects 10-20 % of people with diabetes. The condition of frozen shoulder is mostly found in people aged between 40 and 60 years. Women are more likely to develop frozen shoulder than men.

Frozen shoulder is characterised by pain and extremely stiff shoulders that lead to immobility. It is caused when capsule — the flexible tissue that surrounds the joint — gets inflamed and thickened. Doctors have still not understood why this happens although there are several factors that may lead to frozen shoulder.

Shoulder injuries, diabetes, prolonged immobilisation of shoulder due to stroke or surgeries, Dupuytren's contracture, a condition in which small lumps of thickened tissue form in the hands and fingers, and other health conditions, are some of the known causes of frozen shoulder.

Frozen shoulder develops in three stages: freezing, frozen and thawing. Your doctor will give you a treatment based on the stage at which your frozen shoulder is developing.

1. Freezing is the most painful stage in which the shoulder becomes stiff and starts to lose the range of motion slowly. Typically, this period lasts for 6 months.
2. Frozen is a stage characterised by slow reduction in pain but a more restricted range of motion leading to immobility. This period can last for 4 to 12 months.
3. Thawing is the stage in which the shoulder starts to recover, slowly gains its range of motion and the movement gradually comes back to normal. This period can last for 6 months to 2 years.

Physiotherapy for Frozen Shoulder

Studies show that more than 50 % people who suffer from frozen shoulder may experience the symptoms for as long as seven years after the condition starts. With comprehensive subject history, an accurate diagnosis of frozen shoulder can be performed by your physiotherapist. Your physiotherapist may also use an MRI or ultrasound to diagnose the stage of your condition.

The idea of physiotherapy is to use various techniques to help manage pain and increase the range of motion in your shoulder thereby decreasing the effect of frozen shoulder on your daily life. The physio also aims at monitoring any progression into next stages of the condition.

In order to rehabilitate your frozen shoulder, your therapist may prescribe stretching and other exercises, ultrasound techniques, ice and heat packs, light treatment and other physiotherapy techniques for frozen shoulder. However, you need to note that physiotherapy is not the cure for frozen shoulder. It only helps manage your pain and return to the normal range of motion, and gradually restores your shoulder's mobility.

Frozen Shoulder: Other treatment options

1. Cortisone Injections: Corticosteroids are known to help decrease pain and improve shoulder movement when used in conjunction with physical therapy.
2. Shoulder Manipulation: A general anaesthetic is given to the patient so that he becomes unconscious and feels no pain. The doctor then moves the frozen shoulder joint in various directions to help loosen the tightened tissue. However, the flip side is, if the doctor uses more force, it may lead to bone fractures.
3. Joint Distension: This procedure involves injecting sterile water in the joint capsule to enable stretching of the tissue in order to make the joint movement easier.
4. Surgery: Surgical procedure, such as shoulder arthroscopy or shoulder replacement surgery, is the last resort in the treatment of frozen shoulder. If none of the other treatments work, you may have to opt for a surgical treatment to remove scar tissues and adhesions inside the shoulder joint.