Frozen shoulder

But suddenly a severe pain occurs in the shoulder and the arm can no longer be moved. Sometimes there is a clear cause for the development of a frozen shoulder, such as an accident or an operation, but very often not. About two to five percent of Dutch people will have to deal with a frozen shoulder in their lifetime. Frozen shoulder is a shortening of the joint capsule. The condition is most common in women between the ages of 40 and 70.

Risk Factors

Anyone can get a frozen shoulder, but there are a number of risk factors that increase the chance of it happening. The condition is more common in people with diabetes, heart problems and thyroid disease. About 10 to 20 percent of diabetic patients suffer from a frozen shoulder. It often takes longer for them to recover from a frozen shoulder. Other risk factors include: an underactive or underactive thyroid gland (hyperthyroidism or hypothyroidism), Parkinson’s disease, certain cardiovascular diseases and a small number of rare diseases.

Diagnosis

In most cases, a frozen shoulder is diagnosed through a physical examination. Sometimes it is necessary to further examine the shoulder to rule out any other abnormalities of the shoulder. In that case, X-rays are taken and in some cases also an arthography. This is an examination of joints in which a contrast substance is injected into the joint.

In many cases, no treatment is necessary. A frozen shoulder disappears on its own over time. However, this can take a long time. The course of frozen shoulder consists of three phases:

Phase 1

This is the ‘stiffening’ phase, which can last from six weeks to a maximum of nine months. The pain gradually increases and at the same time the mobility decreases.

Phase 2

This phase is called the ‘frozen phase’. The pain slowly subsides, but the stiffness remains. This phase can last between four and twelve months.

Phase 3

The last phase, the so-called ‘thawing’ phase. The pain fades into the background and mobility slowly returns. This phase lasts about two to twelve months.

The recovery from a frozen shoulder can be speeded up by treatment that focuses on maintaining the mobility of the shoulder joint. By regularly doing certain exercises, the shoulder can be moved better again. Medication such as an injection in the shoulder with a numbing agent and an anti-inflammatory can relieve the pain. Because the pain and irritation is reduced, the shoulder can be moved better.

Operation

If the treatment has no effect, there is the option of removing the capsule with surgery. With keyhole surgery, the haircut is cut loose from the front to the bottom, so that there is more room to move. This is only possible when the frozen shoulder is no longer painful and the active inflammation phase has passed. If the capsule is still inflamed, the operation has no effect, because the capsule immediately shortens after the operation due to the inflammation.