Featured Peripheral Joint Article

Thawing Frozen Shoulders

In an earlier article, we look at what frozen shoulder was all about. In this article, we will look at some treatment options for frozen shoulders

What is the treatment for a frozen shoulder?

A frozen shoulder will usually resolve on its own over a period of up to 2 years. However, it can be very frustrating to live with due the pain and restriction in shoulder movement. The aim of treatment therefore, is to maintain movement in the shoulder and offer pain relief whilst waiting for the condition to resolve.

You can try taking over-the-counter painkillers such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDS) to help reduce pain and inflammation. If these do not provide sufficient relief, see your GP for a stronger prescription.

Applying heat the shoulder can also offer pain relief. This warms up the shoulder to make it easier to move, and easier to sleep at night.

Performing stretching exercises for the shoulder can also benefit in reducing stiffness in the shoulder. Diligent exercise can reduce the chance of severe restriction in the shoulder, which can aid in faster recovery from a frozen shoulder. These exercises will be taught by the physiotherapists.

Physiotherapy can help you in the recovery from a frozen shoulder. A physiotherapist can perform treatment techniques to increase movement in the shoulder joint, as well as reducing pain. They can also show you exercises that are specific to your condition and ensure you are performing them correctly.

Severe and unrelenting pain may require a cortisone injection. This is a steroid injection which may be effective in the reducing pain in the short term. Your GP or specialist will help you decide whether this treatment option is appropriate for your condition.

When conservative treatment fails, more invasive options can be considered. Shoulder distension is a technique where saline water is injected into the joint to stretch the shoulder joint to help allow it move more easily. Another option is manipulation, which can be performed to stretch out tightened tissues. This process is conducted under anaesthesia by an orthopaedic specialist to restore mobility in severely frozen shoulders. Surgery is the last resort for a frozen shoulder. During this procedure, scar tissue and adhesions are removed through arthroscopic surgery to allow the shoulder to move more freely.

What can I do to get better?

It is advised that you see your doctor or a physiotherapist to diagnose your shoulder pain if you are unsure of the cause. If you suspect it is a frozen shoulder, some simple exercises can be performed to help prevent your frozen shoulder from worsening. These should be performed 3 to 4 times a day and should be relatively pain-free, especially if your shoulder is quite painful. See your doctor if your condition does not improve within 3-4 weeks.

Flexion

• In standing, hold a stick horizontally in front of you with hands shoulder-width apart
• With the arms straight, bring the stick from hip level towards the ceiling until you feel your pain come on
• Hold for 5 seconds and return to starting position
• Repeat 10 times

Extension

• In standing, hold a stick horizontally behind you with hands shoulder-width apart
• With the arms straight, bring the stick from hip level towards the ceiling until you feel your pain come on
• Hold for 5 seconds and return to starting position
• Repeat 10 times

External rotation

• Lie on your back and hold a stick horizontal in-front of you with your hands shoulder-width apart
• Bend the elbows to 90 degrees and keep them next to your body
• Using the hand on the pain-free shoulder, push the stick towards the affected side whilst still keeping your hands on the stick
• Hold the end position for 5 seconds and return to starting position
• Repeat 10 times

Internal rotation

• Stand holding a stick with the pain-free arm behind your head, and the affected hand behind your back holding the other end
• Using the pain-free arm, pull the stick up towards the ceiling until you feel the onset of pain in your affected shoulder
• Hold the position for 10 seconds and return to starting position • Repeat 10 times