Frozen
Stiff, Frozen Shoulder? Nagging Pain That Never Goes Away?
Orthopaedic care for your shoulder pain and injury.
How do I know if I have a frozen shoulder?
Shoulder pain and stiffness can be severe and debilitating. It affects your daily function, quality of life as well as mental health. Regardless of how long you have been experiencing shoulder pain, its underlying cause should not be underestimated. A frozen shoulder may be the cause of it.
If you experience the following, we urge you to seek medical attention as soon as possible:
[Symptoms/pain points]
• Shoulder pain
• Shoulder stiffness or loss of flexibility
• Difficulty putting on clothes, especially T-shirts and brassiere.
• Shoulder pain when lying on your side to sleep
• Associated neck and upper back pain
Symptoms may vary from person to person.
Frozen shoulder is a condition which affects women more often than men, patients in their 40s to 60s and are more common in patients with the following medical conditions:
• Diabetes
• Autoimmune thyroid disease
• Depuytren’s disease
• Cervical disc disease
• Previous trauma or upper limb surgery
How would my shoulder be examined, diagnosed, and treated?
Examination and assessment
• Your orthopaedic surgeon will assess your shoulder symptoms and how it has been affecting your daily life. He will also determine if there is an associated cause for it such as diabetes or previous trauma.
• A thorough examination of both your shoulders will be done to assess for flexibility, pain and other associated symptoms. Your neck and upper back will also be examined to exclude referred pain.
Diagnosis
• Frozen shoulder is a condition that is diagnosed clinically. This means that your surgeon will make this diagnosis based on your clinical history and the outcome of the clinical examination of your shoulder. X-rays and MRI scans of your shoulder are not crucial unless they are used to exclude other conditions such as fractures, arthritis or rotator cuff tears.
Treatment
• While the frozen shoulder is essentially a self-limiting condition, it is more prevalent with worse outcomes in diabetic patients.
• The painful and stiff phase of a frozen shoulder may last anywhere from 6 weeks to 9 months. The stiff phase of it may last for another 5 to 9 months while the thawing phase where the patient’s range of motion gradually returns may take another 6 to 12 months.
• It is important to therefore manage the pain and stiffness of a frozen shoulder adequately and supplement anti-inflammatory medication with long-term physiotherapy and stretching exercises.
• Shoulder joint injections with a combination of local anaesthetic and steroids have been used for decades and proven to be very effective in breaking the vicious cycle of shoulder pain and stiffness.
• Surgery for a frozen shoulder may be performed in severe cases where all previous methods have failed over a reasonable amount of time. Key hole or arthroscopic surgery is done to release the thick and contracted shoulder capsule to enable patients more flexibility in their should
How are the shoulder treatments performed?
Treatment 1
Anti-inflammatory medication and physiotherapy
Treatment 2
Shoulder joint local anaesthetic and steroid injection
Treatment 3
Key-hole surgery to release the tight shoulder capsule
Anti-inflammatory medication and physiotherapy are conservative treatment techniques which provide significant relief from shoulder pain and stiffness. They must be followed for several months by a motivated patient to see the benefits of the treatment.
Shoulder joint local anaesthetic and steroid injection may be instituted early on to prevent escalatin of the shoulder pain and stiffness. It allows rapid relief of shoulder pain and enables patients to perform better quality stretching and physiotherapy exercises to accelerate their healing.
Key-hole surgery to release the tight shoulder capsule is the last resort after failure of other conservative methods for 3 to 6 months.
How long will it take for my shoulder to recover?
A frozen shoulder is a self-limiting condition but will take several months to improve. It goes through several phases in which patients feel stiffness and pain before finally regaining some range of motion. Some patients with severely frozen shoulders may take a year or two to recover while some may not fully recover.
The shoulder treatments at BFit Medical & Sports Clinic are designed to optimise your rehabilitation and improve your shoulder function with multiple techniques and approaches. Dr Mizan will customise your treatment plan and enable you to return to your active lifestyles and activities.
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We’re happy to speak with you about any queries you may have.