Frozen Shoulder
Frozen Shoulder(adhesive capsulitis) can be a debilitating condition that results in pain and stiffness of the shoulder. It affects adults in the 4th decade of life and fortunately, it is a self-limiting condition that will usually improve within 2 years.
Frozen shoulder is characterized by 3 stages:
- Painful (freezing) Stage - the slow onset of progressive, worsening pain with associated limitation of movement of the shoulder. This lasts 1 to 9 months.
- Adhesive (frozen) Stage - Pain begins to improve, but severe stiffness and loss of movement of the shoulder is the hallmark of this stage. Usually lasts 4 months to a year.
- Recovery (thawing) stage - there is a gradual return of movement of the shoulder. This stage lasts 6 months to 2 years.
The causes of frozen shoulder include injuries around the shoulder, diabetes, strokes, certain types of medication eg antiretrovirals and shoulder surgery can be a predisposing factor. What happens is that the tissue around the shoulder joints become inflamed and contracted to result in the predominant symptoms.
Treatment involves anti-inflammatory medication, cortisone injections into the shoulder and physiotherapy. The condition will improve given enough time. For patients that are not improving as expected, we can undertake a manipulation of the shoulder joint. This is done in theatre under full anaesthesia and we take the shoulder through a range of movements in an ordered, extremely gentle way. Surgical options include the release of the contracted capsule. This is done arthroscopically through small incisions around the shoulder, inflating the joint with water and releasing the capsule. This usually benefits patients but is only undertaken after a trial of non-operative therapy has failed.