Frozen shoulder

A frozen shoulder (sometimes called adhesive capsulitis of the shoulder or ‘subacromial impingement’) can be very painful and can significantly reduce movement of the shoulder.

A frozen shoulder occurs when the sleeve surrounding the joint becomes thickened and swollen by the formation of scar tissue. This process, which worsens over time, reduces the space available within the joint for the bone of the upper arm (humerus), so reducing movement in the shoulder.

The condition can be painful and prevent patients from carrying out everyday activities. Initial treatment options include the use of painkillers, physiotherapy or corticosteroid injections into the joint. When the condition significantly affects daily life, surgery may be recommended.

A frozen shoulder can occur alongside other conditions, such as calcific tendonitis or ‘rotator cuff tear’ (which affects the group of muscles that controls movements of the shoulder).

The exact cause of a frozen shoulder is often unclear. It may be due to irritation and swelling of the fluid filled sac that surrounds the shoulder joint. It may be due to the growth of bony spurs on the top of the shoulder blade; these usually occur due to osteoarthritis (the ‘wear and tear’ arthritis).

A number of factors can increase your risk of developing a frozen shoulder, including your age (most patients are between 40 and 60), a previous shoulder injury (or surgery) and suffering from diabetes (which can double your risk of developing a frozen shoulder).

The two most common symptoms of a frozen shoulder are pain and persistent stiffness in the joint. These may range from mild to severe, and may become gradually worse over time (a number of months or years).

These symptoms can make the full and free movement of the shoulder very painful, and everyday tasks, such as dressing, sleeping, driving and working, can be difficult to perform.

There are three distinct phases of the condition. During phase one the ‘freezing’ begins, with the shoulder aching and painful when the arm is extended. In phase two, the ‘frozen’ stage, the shoulder may become stiffer but the pain doesn’t necessarily get worse, and the shoulder muscles may begin to shrink through lack of use. Phase three, the ‘thawing’, sees the regaining of movement and the reduction of the pain. Full movement may or may not be regained but everyday tasks become much easier.

Symptoms can include:

  • persistent pain
  • stiffness in the joint
  • reduced movement

Your doctor should be able to diagnose a frozen shoulder after discussing your symptoms and physically examining your shoulder and assessing the range of movement you have. He may refer you to a specialist for further tests and appropriate treatment.

Early diagnosis and treatment is highly recommended to help prevent the persistent stiffness and pain caused by a frozen shoulder.

Arthroscopic subacromial decompression

Subacromial decompression is an operation used to treat a frozen shoulder (or ‘shoulder impingement’). Arthroscopic describes the minimally invasive ‘keyhole’ method of carrying out the procedure, using an instrument inserted through a small incision.

What next?

If you are suffering with a suspected condition, you should seek the advice of your doctor who will be able to refer you to Benenden Hospital for diagnosis and treatment.

There are four ways to access treatment at Benenden Hospital which include self-funding, using private medical insurance or your Benenden membership, or through the NHS e-Referral scheme.