Frozen Shoulder: Understanding Pain, Stiffness and Physiotherapy Treatment
Frozen shoulder, medically known as adhesive capsulitis, is characterized by pain and significant restriction of shoulder movement.
It can make everyday activities such as dressing, reaching overhead, bathing or placing the hand behind the back difficult.
Typical Features
People may experience:
- Gradual shoulder pain
- Increasing stiffness
- Difficulty raising the arm
- Difficulty reaching behind the back
- Night pain
- Reduced ability to perform daily activities
The condition is often described in phases, including a painful phase followed by increasing stiffness and eventually gradual recovery.
Physiotherapy Assessment
A physiotherapist may assess:
- Active shoulder movement
- Passive shoulder movement
- Rotations
- Strength
- Pain severity
- Functional limitations
- Cervical spine and neurological factors where appropriate
A major feature is restriction of passive as well as active movement.
Physiotherapy Management
Treatment depends on the stage and irritability of the condition.
It may include:
- Gentle range-of-motion exercises
- Pendulum exercises
- Assisted shoulder elevation
- External and internal rotation exercises
- Scapular exercises
- Progressive strengthening
- Manual therapy when appropriate
- Education about activity modification
Aggressive stretching is not necessarily appropriate during highly irritable stages because it can aggravate symptoms.
As pain and irritability reduce, rehabilitation can gradually progress toward strengthening and restoration of functional movement.
Early assessment can help identify the problem and guide an appropriate rehabilitation programme.
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