Shoulder Pain

It can occur at any time. Occasionally it can occur after a localised injury but more often it has no obvious cause. There is no evidence to suggest there is a link between frozen shoulder and inflammatory or autoimmune conditions. Sometimes it just happens.

Frozen shoulder often occurs in people over the age of 50 and presents more in females than males, however- there is no discernible cause for frozen shoulder. It is very rare to occur in people below 40 years of age. The likelihood of developing frozen shoulder however is increased if you also suffer from other health problems such as heart or lung disease, diabetes, stroke or other connective tissue disorders.

The three main symptoms of frozen shoulder are:

• Onset of pain with no obvious cause
• Pain that is worse at night or in colder weather
• Loss of mobility of the external rotation of the shoulder

The physio would discuss the nature of the condition, conduct a series of mobility tests to identify range of movement and in some cases request an x-ray to ensure there is no other cause for the movement restriction.

There are also 3 stages of pain and restriction with frozen shoulder. They are:

• Freezing- over a period of 6 weeks – 9 months the shoulder slowly becomes more painful and loses mobility. Forward mobility is generally lost first, followed by mobility in other directions. DO NOT OVERSTRETCH at this stage as this can accelerate the condition and worsen the symptoms
• Frozen- this stage usually persists between 4 – 9 months. Pain during this phase has settled however movement is at its most restricted. Seeking therapeutic treatment at this time has not been proven to show much benefit
• Thawing- Lasting somewhere between 5-26 months this stage is where the pain decreases and mobility returns. This sit he best time to start mobility, stretching and strength training to return the joint to optimum functionality.

Once frozen shoulder has been identified, treatment will include patient specific prescribed stretches initially to increase range of movement. These are best done regularly, up to three times a day. Once flexibility has been restored, strengthening exercises will be prescribed to bring the muscle mass back after not being used for the shoulder, arm, scapula and postural muscles.

For pain management, physical therapies such as mobilisation, heat treatment, ultrasound treatment and the use of a TENS machine (transcutaneous electrical nerve stimulation) that causes contractions in the muscles through an electrical impulse may be used.