Definition Frozen shoulder usually occurs after a person injures the shoulder and does not move it for a period of time because of pain.
What is going on in the body? When the shoulder is immobilised by pain, physical changes take place within the shoulder joint. Adhesions, or abnormal bands of tissue, grow between the bones of the shoulder joint and severely limit movement. In addition, the normal synovial fluid found in the shoulder joint begins to disappear, causing further pain and restricted motion.
What are the signs and symptoms of the condition? Symptoms include severe shoulder stiffness and pain when trying to raise or use the arm.
What are the causes and risks of the condition? This condition can occur after an injury to the shoulder, chest, or head. Any injury that prevents normal shoulder or arm movement may result in a frozen shoulder. Other risks for frozen shoulder include:
Frozen shoulder is most common in middle-aged women or people who have depression.
What can be done to prevent the condition? In most cases, frozen shoulder can be avoided with prompt treatment of the initial injury and active use of the shoulder. Physiotherapy can be useful in promoting proper use of the joint.
How is the condition diagnosed? The diagnosis is usually based on a physical examination , which reveals limited shoulder motion that cannot be explained by an injury or disease. Tests of the shoulder joint may include:
joint x-ray, with or without the injection of contrast media
What are the long-term effects of the condition? A possible long-term effect is chronic shoulder stiffness resulting in loss of strength and permanent disability.
What are the risks to others? There are no risks to others as this condition is not contagious.
What are the treatments for the condition? Stretching exercises are often prescribed to loosen the joint. The doctor may inject the shoulder with cortisone or a long acting anaesthetic. This can decrease some of the pain and allow the patient to stretch the shoulder more effectively. Medications such as non-steroidal anti-inflammatory drugs (NSAIDS) can decrease inflammation and pain. Physiotherapy can be helpful to increase the range of motion in the joint. Manipulation of the shoulder under anaesthesia, also known as arthroscopic capsular release, may be required if exercises and medications are unsuccessful.
What are the side effects of the treatments? Rarely, shoulder manipulation can cause a torn ligament or tendon, or even a shoulder fracture. Allergic reactions may occur with injection of cortisone or an anaesthetic.
What happens after treatment for the condition? Individuals are encouraged to maintain range of motion by doing daily exercises.
How is the condition monitored? The doctor will check shoulder range of motion during regular follow-up visits until the problem has resolved.
Author: John A.K. Davies, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
