Frozen Shoulder/ Adhesive Capsulitis

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Mechanism/Injury:               

Inflammatory condition leading to painful stiffness of shoulder

More common in diabetic patients

Can result from small injury, post-surgery or other pathology

Three phases-   1. Freezing- severe pain followed by developing stiffness

                           2. Frozen- pain abates leaving marked stiffness

                           3. Thawing- movement slowing improves

Spontaneous recovery is normal but varies from 6 to 30 months

 

Symptoms:                           

Severe pain and global restriction of all movements

Severe pain down into upper arm on all shoulder movements

Pain on lying on arm in bed, disturbed sleep

               

Investigations:                     

X-Ray- to rule out arthritis

 

Treatment options:             

Pain killers

Physiotherapy

Injections (steroid/cortisone)

Hyrdodilation- X-Ray guided injection of steroid and normal saline (salty water)

Manipulation under Anaesthetic (MUA)

Arthroscopic/Key hole surgery (see Capsular Release/MUA)