Frozen Shoulder (otherwise known as Adhesive Capsulitis)

What is it, what causes it, who’s more likely to get it and can it be treated and how?

Nigel is one of our more experience Osteopaths and he is keen to help you understand the signs, symptoms and solutions to Frozen shoulder. You can read more about Nigel and his approach to care on our team section.

Nigel works in our Monument clinic and is on hand to help with any questions you have. Check out his availability and book a free consultation is you want to chat in more depth.

Anatomical introduction first, Frozen Shoulder affects the shoulder joint or the Glenohumeral joint, to get technical and is essentially a ball and socket joint. The ball on the top end of the humerus and socket in the shoulder blade.  

Frozen Shoulder (FS) is a complex shoulder condition that is the subject of ongoing medical research and so our understanding is constantly evolving.

Do you or someone you know have a really, really painful shoulder that doesn’t like being moved? You’ll find this post helpful to understand how to manage the issue.

It stretches my little brain but I’ll try hard here to make it understandable and not too technical. If I fail or you want more information then please get in touch, especially if after reading this article you think you may have it.

What is Frozen shoulder?

Frozen shoulder is thought to be a persistent inflammatory condition, which basically boils down to severe pain and stiffness in the shoulder, which can go on for a very long time (3 months and more). 

To make matters worse the prolonged inflammation is thought to trigger something called ‘fibrosis’ of the connective tissues i.e. the ligaments and tendons that crisscross the shoulder joint to give it strength and stability, and the cartilage that lines the joint socket. This fibrosis cause the connective tissues to thicken and scar, producing pain and restricting shoulder movements.      

But how does it start? The truth is there is no consensus in the medical research world. However, it would appear that Frozen shoulder can be secondary to traumatic injury or dislocation of the shoulder in the patient’s history. But this does not apply to everyone and other people develop Frozen shoulder for no apparent reason or from something innocuous like lifting a bag of shopping out of the boot of the car.

The symptoms

The symptoms of frozen shoulder come on gradually over time and with increasing severity before reaching peak pain and stiffness, typically over 4 to 6 weeks or longer. The main symptoms are:

  • Tenderness, mainly in the front portion of the shoulder
  • Reduced range of movement (and pain on movement)
  • Pain during the night especially from resting on the side of the affected shoulder
  • Muscle wastage (through underuse), typically in the late stage of the condition, and
  • Pain on doing usual daily activities

Treatment options

Treatment options including physical therapy and various forms of surgery. Manual therapy comprises joint articulation and mobilisation, message therapy and rehabilitation exercises. It is recommended as an effective intervention in the early stages of the condition when there may be shoulder pain (on movement) but no or minimal stiffness and reduced range of movement. Surgery is usually considered when the shoulder has become really stiff and there is significant reduced range of movement. Surgery is only recommended if symptoms are not responding to conservative management and the symptoms are overwhelming to everyday life.

What to do next?

So my message to you is if you have recently developed shoulder pain, especially if you’re not entirely sure why, make an appointment with me or any of the Just One Body as soon as possible for a full assessment and diagnosis. 

There are other painful conditions that you may have like a muscle tear or tendon injury or a bursitis (inflammation of the bursa that provides cushioning between the tendon of muscle and the bony surface below). So it’s important to differentiate your specific condition so we can get the treatment plan right.

Self help advice

You can check out our Youtube channel for a range of exercises and rehab tips for issues throughout the whole body. Below are some of Nigel's suggested exercises to help manage a frozen shoulder.