| FROZEN SHOULDER | | | | The unusual thing about frozen shoulder is that the |
| Frozen shoulder is the name given to a stiff and painful | | | | capsular pattern of limitation of movement is the same |
| shoulder joint which follows a typical pattern. It is also | | | | in every patient. So all patients still have some |
| known as capsulitis or traumatic arthritis. The patient is | | | | movement out to the side or up in front but are almost |
| usually aged 45 or over and a frozen shoulder most | | | | unable to get their hand behind their back or up behind |
| often occurs on the non-dominant side i.e. the left | | | | their head. |
| handed patient will have a right frozen shoulder and | | | | The shoulder like most joints in the body has two |
| visa versa. A frozen shoulder may follow minor injury | | | | surfaces of bone that are lined with cartilage. These |
| such as a fall or even banging into a doorframe or | | | | surfaces are kept lubricated with fluid which is held |
| slamming a car door awkwardly. The pain only comes | | | | around the joint in a capsule. This capsule is rather like |
| on a week or so after the incident when the pain can | | | | a thick plastic bag which attaches to the edges of the |
| radiate down the arm to the wrist. The pain gradually | | | | bony surfaces and is lax enough to allow movement. |
| increases at first then recedes up the arm into the | | | | In a frozen shoulder the capsule itself becomes |
| shoulder joint over the next 4 months. The patient | | | | inflamed and swollen restricting the movement at the |
| almost always describes the pain as being in the | | | | shoulder joint. It is never a good idea to push a joint into |
| muscle of the shoulder, that is the bulk of the shoulder | | | | pain. If you continue to aggravate the capsule whilst it |
| that gives it its shape. After about a month the arm is | | | | is swollen and inflamed then the movement will only |
| painful even at rest and the patient has difficulty lying | | | | serve to increase the swelling, increase the pain and |
| on the bad side at night. The joint becomes | | | | reduce the range of movement still further. |
| progressively stiffer and more painful at first then the | | | | A GOOD RULE OF THUMB IS 'IF IT HURTS DON'T |
| pain eases and the shoulder remains very stiff. Left | | | | DO IT.' Unfortunately because the onset of frozen |
| untreated the shoulder will not regain full range of | | | | shoulder is gradual most people take almost 3 months |
| movement inside 12 to 18 months. | | | | to realise that the pain in their shoulder isn't getting any |
| Pain and stiffness mean a curtailment of normal | | | | better! If a patient has pain in the shoulder joint lasting |
| activities. Taking the hand behind the back to do up a | | | | for more than a few days it is important to seek |
| bra or a zip is difficult and the patient often finds | | | | professional advice rather than waiting to see 'if it |
| combing their hair painful. Tucking a shirt in or reaching | | | | goes away'. The sooner treatment is commenced the |
| into a back pocket is also usually difficult and painful. | | | | less likely the inflammation is to take hold. |