Overview of Frozen Shoulder
Frozen shoulder, also known as adhesive capsulitis, is a condition that causes stiffness and pain in the shoulder. Over time, it becomes harder to move the shoulder, leading to reduced mobility and discomfort. The condition usually develops slowly and can last for months or even years if untreated.
The condition usually goes through three stages: freezing (pain worsens), frozen (stiffness sets in), and thawing (gradual recovery). Early diagnosis and treatment can help reduce symptoms and improve movement.
Non-Surgical Treatment Options
Most cases of frozen shoulder are treated without surgery. These treatments focus on reducing pain and improving movement.
Pain Management (Medications)
Over-the-counter pain relievers, such as ibuprofen, are commonly used to ease pain. If the pain is more severe, an orthopaedic specialist may prescribe stronger medications for short-term relief. These medications do not fix the underlying problem but can make it easier to perform physiotherapy and other treatments.
Steroid Injections
Corticosteroid injections may be used to reduce inflammation and provide temporary pain relief. These injections are given directly into the shoulder joint and are most helpful in the early stages when pain is most severe. However, the effects of steroid injections may wear off over time, and repeated use can have side effects. They do not address the long-term stiffness that comes with frozen shoulder.
Physiotherapy
Physiotherapy is a key part of treatment for frozen shoulder. Through specific exercises, patients work on improving their shoulder movement. A physiotherapist will guide patients through stretching and strengthening exercises, adjusting the plan as needed. Regular physiotherapy can help restore shoulder movement and reduce stiffness over time, although the process may take several months depending on the severity of the condition.
Hydrodilatation
Hydrodilatation is a procedure where a saline solution is injected into the shoulder joint to stretch the joint capsule. A corticosteroid may also be added to reduce inflammation. This procedure aims to increase the space in the joint, allowing for better movement and less pain. Hydrodilatation is often considered when other non-surgical treatments have not been effective.
Surgical Treatment Options
Surgery may be considered if non-surgical treatments do not improve symptoms after several months, and the patient continues to experience significant pain and restricted movement. Surgery aims to release the tight shoulder capsule and improve mobility.
Manipulation Under Anaesthesia
During manipulation under anaesthesia (MUA), the patient is put to sleep with general anaesthesia, and the orthopaedic surgeon manually moves the shoulder to break up scar tissue and improve movement. While this can help, there are risks, including the possibility of fractures or damage to surrounding tissues. This procedure is usually reserved for cases where non-invasive treatments have not been effective. After the procedure, physiotherapy is important to maintain the improved movement.
Arthroscopic Capsular Release
Arthroscopic capsular release is a minimally invasive surgery where the orthopaedic surgeon makes small cuts around the shoulder and uses a camera to guide specialised tools into the joint. The tight areas of the joint capsule are carefully cut to improve movement. This method is more targeted than manipulation under anaesthesia and allows the orthopaedic surgeon to see and treat the areas causing stiffness. After surgery, patients typically follow a physiotherapy programme to regain strength and flexibility, and many people gradually return to normal shoulder function.
Conclusion
Frozen shoulder can make everyday activities challenging due to pain and limited movement. Early diagnosis and non-surgical treatments, like physiotherapy, pain relief, and steroid injections, can often help manage symptoms and improve movement. In cases where these treatments do not provide enough relief, surgery may be necessary to restore mobility. Working with an orthopaedic specialist can help determine the best treatment plan based on the severity and stage of the condition.
Are your shoulder symptoms affecting your quality of life? Consult our frozen shoulder specialist today for a comprehensive & accurate diagnosis.
