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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