One of the common shoulder disorders that present in the clinic is frozen shoulder (also known as adhesive capsulitis) which causes stiffness, pain and reduced range of movement in the shoulder, which gradually becomes worse. If you facing frozen shoulder symptoms you will require read on. You might need a Shoulder Pain Treatment in Guildford.
Patients may report not being able to lift their arm up to do the simplest of tasks, such as combing their hair, doing up a bra strap or even putting on a jacket, which is frustrating debilitating. The pain is constant and especially during the night can prevent sleep. This condition can affect both males and females, though it is four times more prevalent in females and more commonly in their 40-60’s +. (Murakami et al., 2018) (Kingston et al., 2018)
A lot of the time patients report just an insidious onset of the frozen shoulder symptoms becoming gradually painful and stiffening up. Others may report an associated incident linked to their frozen shoulder which may be from physical trauma or injury, or overuse injury. Frozen shoulder is also associated to patients with diabetes, which may have links to glycosylation (bonding of blood glucose to the red blood cells). This can affect the shoulder joint due to it being triggered by the presence of high blood sugars. (Goldin et al., 2006) (Hsu et al., 2016). Another cause of Frozen shoulder onset it thought to be linked with emotional trauma or stresses, though there is little evidence to confirm this.
So, what’s causing the shoulder to feel stuck?
The shoulder joint (also known as the glenohumeral joint) is covered by a capsule, which holds synovial fluid. The fluid helps protect, nourish the joint, allowing it to move smoothly.
At the bottom of the capsule is a small recess (axillary recess) of the capsule that allows the shoulder capsule to raise the arm above the head. As the shoulder becomes less mobile the synovial fluid and the capsule becomes thick causing sticking of the capsule.
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Due to the reduced movement of the shoulder, the muscles are moving less and becoming more fibrotic. This leads to muscle wasting and weakness of the shoulder.
Stages of frozen shoulder
There are three stages to this condition.
- Freezing stage – The shoulder becomes more painful and less movement and stiffness occurring. This can occur from approximately 6-9 weeks
- Frozen stage – There is usually less pain but noticeable difference n the range of movement and limitations and difficulty carrying out daily tasks. The arm is usually limited to less than 90 degrees abduction. This can last from 4-6 months
- Thawing stage – This stage is where the shoulder slowly improves it range of movement, either completely or improved. This can take up to 18 months + to recover from.
Shoulder Pain Treatment in Guildford.
An initially conservative approach in the form of manual therapy is advised to help with restoring joint mobility and well helping manage pain. Shoulder Pain Treatment in Guildford can include exercise to help with building strength through the shoulder joint. Joint mobilisation has been shown to be an effective way to encourage movement and assist in restoring movement (Vermeulen et al., 2006) (Johnson et al., 2007), In addition, Low Level Laser therapy (LLLT) has also been shown to be effective in treating shoulder disorders including frozen shoulder. (Awotidebe et al., 2015) (Ip et al., 2015) and Graston Technique (instrument assisted soft tissue therapy)
Exercises
Exercises can be given to help improve shoulder movement, as well as help to rebuild some of the muscles that may have wasted due to the lack of movement.
Pendulum exercises can help with mobility of the joint capsule. This exercise can also be carried out with a light weight, which encourages traction of the capsule as well as the arm allowing muscles to work under low resistance. This can be carried out with or without a weight. Using a weight will help to create more traction through the shoulder stretching encouraging movement.
Using a ball placed either against a wall or on a table acts as a fulcrum to glide the arm as far as possible to encourage mobility of the shoulder. Using resistance band can also be used to strengthen the shoulder.
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Conclusion
Research suggests manual treatment along with exercises are effective for treating Frozen shoulder and are a preferred option in the first instance. If treatment fails, patients may require a corticosteroid injection in the shoulder. The shoulder will still benefit from the continuation of treatment and exercises after to encourage and restore movement.
If you are suffering with a Frozen shoulder or need Shoulder Pain Treatment in Guildford, make an appointment to see our associate Osteopath Jason Bianchi here at Kinesis Clinic, Guildford
