The treatment approach to frozen shoulder depends on the stage of the condition and how severe the symptoms are. The majority of sufferers find that the pain and stiffness gradually resolves over a period of a couple of years. However, for some people, the condition persists and does not improve for 5 years or longer.
The treatment of frozen shoulder is aimed at:
- Easing pain
- Improving arm and shoulder movement
- Preventing further injury as the shoulder heals
An outline of the treatment for frozen shoulder is described below:
Early stage treatment
In the early stage of frozen shoulder, pain is the main symptom. Treatment is mainly focused on relieving this pain and patients are advised to avoid movements that make the pain worse. Painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs), codeine, ibuprofen or paracetamol may be prescribed to relieve pain and reduce inflammation.
If pain killers fail to provide pain relief, the injection of corticosteroid directly into the shoulder joint may be recommended. This can help to relieve pain and inflammation as well as improving movement in the joint. Corticosteroid injections are only given in cases where the patient feels pain as well as stiffness and not when the pain has gone and only stiffness remains.
The effects of corticosteroid injection diminish over time, so the physician may recommend no more than three injections, separated by periods of three or four weeks.
Later stage treatments
Following the pain felt in the initial stage, stiffness is the next main symptom of frozen shoulder. The doctor may recommend stretching exercises because it is important to keep the joint mobile. Not using the joint can worsen the stiffening and restrict movement even further. Physiotherapy may also be prescribed, which uses several techniques to help the patient keep their shoulder flexible and moving. The techniques include stretching exercises, massage and hot/cold treatments.
If none of the above therapies improve symptoms within six months, surgery may be recommended. Several surgical techniques exist to treat this condition including manipulation under anesthetic (to move the shoulder and stretch the shoulder capsule); arthroscopic capsular release (keyhole surgery to cut out thickened segments of the shoulder capsule) and arthrographic distension (hydro dilatation) which involves a mixture of saline, corticosteroids and local anesthetic being injected into the shoulder joint under X-ray guidance.
Reviewed by Sally Robertson, BSc