Wellness Osteo

Wellness Osteo

At Wellness Osteo, we are osteopaths who focus on achieving optimal health and wellness, which means treating you and sharing our expertise with you. Read on for the ins and outs of osteopathy.

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Frozen Shoulder

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What is Frozen shoulder?

Frozen shoulder, also known as Adhesive capsulitis, occurs when there is a thickening of the shoulder capsule. Or in other words, in your shoulder joint, there is some cartilage that stops the bones rubbing on each other, and creates a capsule for your humorous (arm bone) to sit in the shoulder joint. This capsule can become inflamed and then thickens, resulting in pain and limited range of motion in your shoulder. 

 

Causes of frozen shoulder 

Frozen shoulders cause is unknown, but what is known about it is it is most common in 40-70 year olds, and you have an increased risk of developing frozen shoulder if you have diabetes, hypertension, COPD or are overweight.
It is important to get Frozen shoulder properly diagnosed by imaging, as it presents very similarity to many shoulder conditions. 

 

Symptoms of frozen shoulder

Frozen shoulder has an insidious, slow gradual onset. This means it develops out of nowhere, and slowly gets worse over time. Its common symptoms include gradual loss of shoulder motion, diffuse, stiff, deep shoulder pain that can cause sharp pain on sudden movements. Shoulder pain can wake you, and is uncomfortable but not impossible to sleep on and colder temperatures increase the pain. 

 

There are 3 stages to Frozen shoulder:

– Stage 1: “The Freezing Stage”. This stage is where the inflammation is forming and increasing gradually. This can last anywhere from 6 weeks to 9 months, and you will notice a slow decrease in range of motion in your shoulder.
– Stage 2: “The Frozen Stage”. This is the stiffening stage. The stage where the capsule in your shoulder starts to stiffen up, motion becomes increasingly difficult and activities of daily living, like getting dressed or brushing your teeth become very hard. This is also the longest stage, usually starting around the 6 month mark and can last another 6-12 months afterwards.
– Stage 3: “The Thawing stage” where range of motion in the shoulder slowly starts to be recovered. This thawing stage can last anywhere from 6 months to 2 years to fully recover.  

 

Management and treatment of frozen shoulder

Although movement becomes increasingly difficult, you need to keep the shoulder moving as much as possible. Manual therapy can greatly assist with moving the shoulder in ways you can’t do yourself, but a huge emphasis is also placed on exercise. Exercise has been shown to be just as effective as surgery, so even though surgery is an option, you will have to still do rehab after surgery.
It has been shown that it is a slow process, and it may take 3-6 months of treatment from an allied health professional to show any improvements and it is very rare for frozen shoulder to be fully resolved in less than 18 months. But improvements do occur and you will get better if you stick to the plan, so be patient and keep believing you will get better. 

Goals of treatment should include making activities of daily living easier, like tying your shoes, getting dressed, brushing your teeth and reaching for everyday objects. 

Hydrodilatation injections are a good treatment option but should not be heavily relied upon. They involve a large amount of fluid being injected into the joint to provide more range of motion by stretching the joint out. It usually gives more movement for about 1 week, but will cause more pain. You should keep up your exercises if you get an injection as the fluid won’t stay in the joint for more than 2 weeks and you will go back to your pre-injection range of motion if you don’t keep it moving.