Continuing our popular medical series, Dr Ciaran Roarty of Scally McDaid Medical Practice this week addresses the issue of a frozen shoulder.
What is it?
Frozen shoulder is a condition where a shoulder joint becomes painful and stiff with limited range of movement. The symptoms can interfere with routine daily tasks such as driving, getting dressed and sleeping. It may even affect our work. There are usually three phases with the condition and patients move gradually from one phase to another.
1. The ‘freezing’, painful phase: This lasts about 3-9 months and the pain is usually worse at night and when you lie on the affected side.
2. The ‘frozen’, stiff (or adhesive) phase: This lasts about 4-12 months. The pain gradually eases but stiffness and limitation in movement remain and can become worse.
3. The ‘thawing’, recovery phase: This can last for 1-2 years. The pain and stiffness gradually go and movement slowly returns to normal, or near normal.
It is quite common, affecting about 3% of people at some stage in their lives. The usual age group affected is between 40-65 and women are more commonly affected than men. It usually affects the non-dominant shoulder ( ie left shoulder if you are right handed etc).
What causes it?
The cause is not clear and most cases occur for no apparent reason. It is thought to be related to scar tissue forming in the capsule of the joint. Interestingly it is not a form of joint inflamation (arthritis) and other joints are not affected.
Are there any tests needed ?
The diagnosis of frozen shoulder is usually made after a doctor’s examination.
You may require an xray or MRI if the diagnosis is not clear cut.
It is really important to keep moving your shoulder as the ultimate aim of treatment is to ease pain and stiffness while keeping the range of movement of the shoulder as good as we can while it settles.
One or more of the following can also help ease symptoms.
1. Pain relief –Paracetamol +/- Codeine
2. Anti-inflammatory medication – This eases pain while also reducing inflamation.
3. Shoulder exercises – to keep the shoulder from ‘stiffening up’ and to keep movement as full as possible. Your doctor may show you some of these.
4. Referral for physiotherapy may be required. Physios can give expert advice on the best exercises to do. They may also use other pain relieving methods such as warm or cold temperature packs and nerve stimulation machines.
5. Steroid injection. This helps relieve inflamation and while not a cure, it may give some relief for a period.
6. Surgery in hospital. This may sometimes be considered if other methods are not helping as it does not help all cases.
Will it get better Doctor?
The symptoms of frozen shoulder can continue for quite a period of time – from 18 months up to 3 years or more. However, most people recover to normal levels of function and mobility by two years, even without any treatment!
The above information is intended as advice only and should you have any concerns contact your own Doctor.
Dr Ciaran Roarty MB BCh BAO MICGP DRCOG is a full-time GP at Scally McDaid Medical Practice , Scally Place, Letterkenny, Tel 0749164111.