Frozen shoulder, complaints, surgery and excercises during rehabilitation

What is a frozen shoulder?

There are two types of frozen shoulder. First there are ideopathic occurrences of frozen shoulder, a collective name for all frozen shoulders for which no clear cause can be identified. We do know, for example, that diabetes and thyroid problems involve a clear increase in the risk of a frozen shoulder occurring. Secondly there is the occurrence of a trauma involving the shoulder. The shoulder capsule becomes inflamed and adhesions - thickening of the capsule occur.

Symptoms related to a frozen shoulder

A painful shoulder (also the upper arm) is the primary complaint. There may also be mobility limitations, rotating the arm outwards is often extremely painful. Sudden movements and reaching for something are painful too. We differentiate between three phases in the course of a frozen shoulder. The first is the freezing phase, followed by the frozen phase and lastly the thawing phase. The period each phase lasts varies and may take between two and nine months. During the freezing phase the pain is intense and mobility gradually decreases. The patient notices that movement becomes more and more restricted and is in constant pain, also at night. Physiotherapy is also extremely painful. During the frozen phase the pain gradually decreases, but restricted mobility persists. Finally, during the thawing phase the shoulder joint progressively becomes suppler and the pain subsides.

Frozen shoulder diagnosis

The diagnosis is made during a clinical examination. Technical tests are usually unnecessary.

Frozen shoulder treatment

A frozen shoulder usually disappears by itself, over the course of several months to one and a half years. The aim of the treatment is to limit the complaints as much as possible. With regard to the pain, adequate pain medication (such as anti-inflammatory medication) is used, especially in the first phase. In some cases a cortisone injection may offer relief. However, if mobility is severely restricted a mobilisation is performed under general anaesthetic or the shoulder is loosened via keyhole surgery. The doctor will discuss with you what the best solution is in your particular case. It is also vital that you follow adequate physiotherapy. Its aim is to retain and improve flexibility of the shoulder (not usually in the first phase due to the pain).

This content was written by : Dr. Yves Devlies, Dr. Stijn Muermans, Dr. Peter Stuer, Dr. Alexander Ryckaert, Dr. Karel Willems