Frozen shoulder contracture syndrome
What is Frozen shoulder contracture syndrome?
Frozen shoulder contracture syndrome is a condition that affects part of the lining of the shoulder joint called the rotator interval as well as one of the shoulder joint ligaments. The rotator interval becomes very inflammed and the ligaments within the area thicken.
Frozen shoulders are usually characterised by severe pain (although they do come in milder forms), worse at night and there is usually concurrent joint stiffness.
Frozen shoulders have classically been described as following a set pattern of three stages:
1. Freezing stage: the shoulder is very painful and begins to lose movement
2. Frozen stage: the shoulder is very stiff and painful
3. Thawing stage: the shoulder pain resolves and the movement slowly returns
We now know that not every frozen shoulder will follow this linear path and that the length of time for each stage will vary considerably from person to person.
A frozen shoulder can last for as little as 9 months in less severe cases, or up to 3 or 4 years in the most severe cases. Between 1 and 2 years is normal for all symptoms to go.
Frozen shoulder is a self limiting condition and symptoms will pass eventually.
Given the often severe nature of the pain it is usually recommended that you have some treatment to improve things.
What is happening to cause the symptoms?
There is still a great deal of uncertainty as to what causes frozen shoulder. There is evidence that the bodies immune system targets the lining of the shoulder joint and that this triggers lots of inflammation (which causes the pain). As part of this process small scar tissue factories in the joint lining become very active and it is the production of this scar tissue that causes the stiffness.
Because it usually affects people at a certain age (45-65), and can run in families there is a thought that there may be a genetic link to the condition but this has not been proven.
If you are diabetic or have thyroid problems you are at a slightly higher risk of developing the symptoms, and slightly higher risk that these will take longer to go.
If your frozen shoulder has come on after a traumatic injury you should ask for a referral to us from your GP so we can make sure you haven't injured the bones or tendons.
What is the treatment?
For some people the condition will be mild and clear up on its on so no specific treatment is indicated.
For most people the pain is quite severe. This is caused by the inflammation so injecting a corticosteroid into the joint is often the best pain relieving treatment available (as steroid injections are strong antiinflammatories). It is recommended to have between 1 and 3 injections for the pain over the course of the condition (everyone requires a different number).
Once the pain has settled the joint will still remain stiff for sometime. We don't recommend physiotherapy prior to the pain settling as most people simply find it too aggrevative of their pain. Once the pain has gone however stretching may help to get your movement back quicker.
Below are some simple stretches for people with stage 3 (stiffness only) frozen shoulders. Remember even if you exercise regularly it may still take a number of months for the movement to return.