Sunday, 27 September 2015

My Shoulder is Frozen!

Have you ever had a shoulder joint that’s painful and restricted?  The chances are you probably thought it was a ‘frozen shoulder’ – and the chances are you were probably wrong!

As with some of the previous terms we’ve discussed, such as sciatica and migraines, the problem lies in part with the difference between what you might mean by ‘frozen shoulder’ (it hurts and I can’t move it properly) and what a musculoskeletal specialist means by ‘frozen shoulder’ (very specifically, adhesive capsulitis) … and differentiating between the two is very important as they can have very different treatments and outcomes.

The shoulder is the most complicated joint in the body – in fact, it’s not one joint at all, it’s three joints plus the articulation between the shoulder blade and the top seven ribs.  If it’s going to work properly, there are over 100 joints, muscles, ligaments and bursae that have to we working normally and integrate smoothly.  Fortunately, of all the things that can go wrong, frozen shoulder (or adhesive capsulitis as we should call it from now on) is one of the less common.

So have you got adhesive capsulitis, or is it something else causing your shoulder pain?  First of all, if you’re under 50 years old, it’s highly unlikely you’ve got adhesive capsulitis unless you have other health problems such as diabetes.  If you’re over 50, there’s a simple test you can do: take off your shirt and lift your arms up sideways as far as they will go (which probably won’t be that far). If your shoulder blades swings out more quickly on the affected side, it could well be adhesive capsulitis … but, unfortunately, that won’t be all that’s wrong with your shoulder.

Although the mechanism that causes bits of the shoulder joint capsule to stick to other bits (adhesions) is complicated and poorly understood, it is almost invariably the case that it is triggered by something else going wrong with the shoulder, either one of those common conditions (tendinitis, impingement, bursitis etc) or by trauma such as a fall or particularly after a broken arm when the shoulder (and the rest of the upper limb) has been immobilised in a splint.

There are a number of treatments available – it’s a condition that chiropractors see every week, and their techniques are clinically proven to help restore mobility and reduce pain.  Although, in skilled hands, steroid injections can often produce rapid relief, twenty years clinic experience has taught me this: if you haven’t got rid of the underlying condition that triggered the condition, it will rapidly return.

A true ‘frozen shoulder’ is a disabling condition that can rapidly become entrenched and chromic so, if you’re in the risk groups for adhesive capsulitis, my advice is to seek rapid care from a musculoskeletal specialist as soon as possible for any shoulder conditions that arise, no matter how innocuous they may seem initially – an ounce of prevention can be worth months of cure!

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