Definition and cause
The term frozen shoulder describes a state of unprovoked, newly emerged pain and movement restriction of the shoulder of at least 4 weeks.
There is an inflammation of the joint capsule surrounding the shoulder joint. This results in pain, and the capsule enlarges and becomes thicker, resulting in curtailed freedom of movement of the shoulder. It is not known exactly what causes this condition, but the condition is thought to be associated with slight shoulder injuries, tendon inflammation or bursitis.
It is believed that around 2% of the population will be afflicted by a frozen shoulder during a lifetime, women are slightly more often affected than men. Frozen shoulder is seen mostly between the 40 to 60 years, and is equally frequent in both shoulders.
Symptoms of frozen shoulder
The disease picture can be divided into 3 phases:
The first phase lasts 2-6 months, and here gradually incresing pain in the shoulder is seen. The pain is often worst at night, and often radiates into the arm. After a few weeks impaired movement of the shoulder develops.
The dominant symptom in the second phase is a clear limitation of movement commonly to such an extent that the shoulder can barely be moved. In contrast to the diseases of muscles, tendons and nerves the shoulder is completely stiff and can not be moved even by passively moving in the arm. The second phase lasts from 6 to 12 months.
The third phase is the restitution phase, and it may take up to 3 years. The shoulder slowly improves and slowly regains most of its function. The vast majority will be completely healthy again.
Precautions and diagnosis
Diagnosis is made by the physician based on the pain and restriction of movement of the shoulder even when the shoulder is moved passively. X-ray of the shoulder is normal, but is used to exclude other diseases or fractures in the shoulder region.
An MRI scan show thickening of the capsule around the shoulder joint.
As the condition is often seen without any particular reason no special precautions can be taken to prevent frozen shoulder. However, it is important to seek medical attention if you experience prolonged pain in your shoulder.
Treatment of frozen shoulder
The vast majority of cases heal themselves over time, and teatment is thus primarily relief of the shoulder, possibly supported an arm bandage. In addition the pain may be relieved with painkillers and anti-inflammatory agents, such as aspirin and NSAIDs e.g. Ibuprofen, Ibumetin or similar. Light gymnastics and physiotherapy is an important part of the treatment.
Injection of cortical steroid hormones can be given directly in the shoulderjoint. This reduces the inflammation temporarily, and can relieve pain and allow increased movement.
Prognosis and complications
As mentioned, the overwhelming percentage will be completely healthy after an average of 30 months illness. A few may however experience chronic impaired function of the shoulder.