Dealing with frozen shoulder

Hands on a woman's shoulder. Pain in the muscles.

Frozen shoulder may begin as a little discomfort, it can turn into a painful condition that affects your ability to carry out simple day-to-day tasks. If you're worried pain or stiffness in your shoulder, here's what you need to know.

What is frozen shoulder?
The condition occurs when flexible tissue surrounding the shoulder joint becomes inflamed and thickened. Although it is unclear why some people suffer from the condition, if you have had previously injured or had surgery on the shoulder, are diabetic, have Dupuytren's contracture (thickened tissue in the hands and fingers), or have suffered a stroke or heart disease, you may be more at risk. According to the NHS, one in 20 people in the UK will be affected by frozen shoulder at some point, typically between the ages of 40 and 60, and women are more commonly affected than men.

Pain and persistent stiffness in the shoulder joint are the main symptoms of frozen shoulder. Though the symptoms vary from mild to severe, they generally worsen over time. In the early stages, you may find your shoulder aches or causes pain when you reach for things, and it is often worse at night, particularly if you lie on the affected shoulder. Known as the 'freezing' phase, this may go on for anything from two to nine months. Thereafter, the condition reaches the 'frozen' phase (typically lasting from four to 12 months), where stiffness increases, while the pain may stay the same or even decrease. At this stage there is a risk of muscle wastage in the area, since it is not being used. Finally comes the 'thawing' phase, where the pain begins to fade, although stiffness may recur from time to time. You may be able to carry out more everyday tasks, but in some cases, you may not regain full movement in the shoulder.

Diagnosis and treatment
If you suffer persistent pain or stiffness that limits your movement, affecting your ability to perform daily tasks such as bathing, dressing, driving or sleeping, you should see your GP. Early diagnosis, which may help to prevent more long-term effects, usually consists of a physical examination where your doctor will test the range of movement, and apply pressure to determine the level of pain. Further tests may be needed to rule out other conditions that may be the cause or the root of the problem, such as a blood test for diabetes, or an X-ray or scan to check for signs of arthritis or injury.

Treatment will vary depending on the stage of the condition and the severity of the symptoms. Though frozen shoulder may get better left alone, it can take as long as two years if left untreated. In the first and most painful stage of the condition, pain relief such as ibuprofen or paracetamol can help to ease the symptoms, and your doctor may recommend avoiding certain movements, though you should not stop moving altogether. Where the pain is severe, corticosteroid injections may be prescribed, though typically no more than three will be offered, as too many can damage the shoulder further.

As the pain begins to subside and the stiffness sets in, you may be referred to a physiotherapist to help retain as much movement as possible. As mentioned, not using the shoulder at all can make things worse, but it is nevertheless important to get advice on the correct types of exercises and stretching movements. Massage and thermotherapy (the use of warm or cold packs) may also be recommended.

The need for surgery is rare, but if the symptoms are very severe and other treatment methods have failed even after six months, you may be referred to an orthopaedic surgeon, who may manipulate the shoulder under anaesthetic, or perform keyhole surgery to help open up the capsule (the tissue surrounding the joint).

Though frozen shoulder often gets better over time, even without treatment, prescription medication and physiotherapy can make a real difference. So if you're beginning to feel pain and stiffness, visit your GP.

Have you suffered with frozen shoulder? What advice would you give to others with the condition? Leave your comments below...
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