‘Frozen shoulder’; shoulder adhesive capsulitis
The main shoulder joint is formed between the ‘ball’ at the top of the upper arm bone (humerus) and the ‘socket’ that is part of the shoulder blade (glenoid cavity). The joint is surrounded by a bag or ‘capsule’ that has an inner lining that produces a lubricant fluid to help shoulder movements. ‘Frozen shoulder’ describes a stiff, painful shoulder occurring in middle-age that may come on after minor trauma or spontaneously. The capsule and its reinforcing ligaments (‘elastic bands’ that are placed to prevent overstretching of the joint) are affected and the joint gradually stiffens with scar tissue forming within the joint. Patients complain of pain on lifting the arm into the overhead position or placing the arm behind the back. A proper diagnosis is needed as shoulder pain can also come from the neck or arise from structures being pinched at the shoulder. The pain tends to settle in approximately two years without treatment but the stiffness can remain unless the joint is stretched.
Physiotherapy can help the condition to settle more quickly with mobilising and stretching techniques, applied at the right stage of the condition, with an explanation of the condition, reassurance and home exercises. A steroid injection, or a series of injections, may be given if the pain is persistent.