Shoulder pain is one of the most common conditions we treat as physios. Many people attend the clinic with a sore, stiff shoulder, worried they may be developing a frozen shoulder. They’ve heard horror stories from friends at a BBQ about a long drawn our rehab and are panicking that this will be their fate too.
We understand frozen shoulder sounds like a terrible diagnosis and more often than not it is probably not the cause of your symptoms. Remember everyone is different and we always recommend an assessment with a health professional, however we’ve put together a list of some signs that may indicate your shoulder might be freezing.
Did you know?
The more correct name for frozen shoulder is adhesive capsulitis.
But even this is a misnomer – Adhesive capulitis was first defined in 1945 and it was thought the shoulder capsule ‘stuck’ or adhered to the shoulder ball and socket causing it freeze.
Now we know the condition is caused by excessive growth of blood vessels into the tissue which causes increased collegen production making the capsule stiff.
Do you have pain?
This might be a surprise to some but there are conditions in the shoulder that cause it to become stiff that aren’t painful. During the initial stages of frozen shoulder however, patients describe severe, unrelenting and constant pain. It is worse when they attempt to move the shoulder (or someone else tries to help them move it) and they can seldom find anything to ease it.
For some people the pain comes on gradually whereas for others it is more sudden. Similarly the location of the pain does little to either confirm or reject a diagnosis of frozen shoulder. It might be quite localised or more diffuse and widespread. Some people even describe the pain as being similar to a pinched nerve
Has your shoulder movement decreased?
A key feature of frozen shoulder is the decrease in the ability to move the shoulder freely. Like pain shoulder movement may gradually decrease as the shoulder is freezing or be more sudden.
An important differential is whether the decreased movement is caused by weakness and pain or whether the joint has truely become stuck. For example, patients with tears in their rotator cuff muscles may experience pain and weakness due to their injury, which limits their ability to move the shoulder – this is called their active range of movement. Frozen shoulder will also cause a loss of active range of movement AND passive range of movement (the amount of movement in the joint if someone/something else moves it).
Have you had a previous or current shoulder injury?
Local trauma, shoulder surgery, rotator cuff injury or an infection in the shoulder all increase the likelihood that new blood vessels will grow into the shoulder joint capsule starting the cascade of events that lead to frozen shoulder.
Do you have any systemic risk factors?
If you’ve been diagnosed with medical conditions like diabetes, hypothyroidism, cardiovascular disease, or you have a genetic condition like dupuytrens contractures you are more likely to develop frozen shoulder.
How old are you?
Frozen shoulder is much more common in people aged 40-60years.
Are you female?
It is reported that frozen shoulder incidence is 3 x more common in women.
All that being said the actual incidence of frozen shoulder is perhaps much rarer than you’d think at only 2-5% cases. In many cases shoulder pain and stiffness is misdiagnosed as frozen shoulder and left untreated when much more could be done to assist with reducing symptoms and maintaining function.
The best recommendation is to have your shoulder properly assessed by a movement expert like a Physiotherapist. We are trained to look at the entire picture not just your shoulder in isolation. There are many factors that go into the diagnosis of shoulder pathology AND if it does turn out that your shoulder is freezing there are strategies we can use to assist you to effectively it.