Mr Andrew Chambler

Consultant Orthopaedic Surgeon & Shoulder Specialist

Circle Bath Hospital

01761 422 222

Frozen shoulder

The shoulder is a complex joint. Known as a ‘ball and socket joint’, it provides us with a good amount of movement in our upper arm, from throwing to pulling, pushing to rotating. When something goes wrong with the shoulder joint, we can lose some of that mobility and function and this can have quite a detrimental effect on our quality of life.

A ‘frozen shoulder’ is the term used to describe the shoulder joint when it is very inflamed, with contracted tissue in the capsule of the joint. Somebody suffering from a frozen shoulder will usually experience pain in it at first, but they may then also lose some mobility in the joint as well. Frozen shoulder can sometimes mimic the symptoms caused by a tendon or nerve impingement, so it’s important that an accurate diagnosis is made.

Statistically, you are more at risk of developing a frozen shoulder if you are a male. There is data showing that it is also associated with females who have diabetes. If you have previously had a trauma to the shoulder, like a fall onto it or a big impact when playing rugby for example, that can also set it off.

Unfortunately, we don’t yet fully understand the true cellular mechanism of a frozen shoulder. There is ongoing research to try to learn more about it, and we know that it is linked with the ability of cells to contract somehow being ‘switched off’ in certain situations. Beyond that, hopefully research will help us learn more about the exact causes in the future.

The main problem with a frozen shoulder is that it can last for a prolonged period of time. The condition will resolve itself naturally in the majority of people, but this may take 18-24 months. There is no fixed duration for a frozen shoulder, it varies for each person.

Some people may be content to leave it to resolve naturally, although in my experience most people prefer to take a more proactive approach to treatment so that they can regain their mobility and function and (most importantly), not be in pain anymore.

In fact, lots of people who come to see me say, ‘I want the pain gone, I want my shoulder back and I want my life back; and I want it tomorrow, not in two years' time’.

People can try some steroid injections to try and reduce the inflammation. These can help reduce the actual pain, but don’t quicken the overall recovery. In addition, the stiffness can remain, and this can be very debilitating.

An effective way of treating a frozen shoulder is through surgery, with what is called a ‘capsular release’. This is keyhole surgery, using a very fine tube known as an arthroscope. With only a few very small cuts, I’m able to access the shoulder joint and ‘release’ the joint by removing all the inflamed tissue within it. This creates more space for the tendons, which are able to begin working normally again.

It is a day case procedure, meaning you will be able to return home the same day. The difference with this treatment is that physiotherapy needs to be given immediately after the surgery, in order to help maintain the range of motion in the shoulder. Usually after an operation, we advise waiting a few days for things to settle down before having physiotherapy. A capsular release for a frozen shoulder is one of the few times we say that physiotherapy is important straight away 

Many people really benefit from having a regional anesthesia. This is a nerve block that will keeps your arm numb for 12-18 hours after the surgery. This provides you with the ability to move your shoulder freely, straight away, without any pain. This is incredibly beneficial in helping you retain the mobility in the shoulder that the surgery has just made possible. From talking with my patients, this surgery is well tolerated and has a high success rate. The results are very quick too – almost immediate.

If you’re struggling with a frozen shoulder, or any other shoulder problem, it’s easy to arrange a consultation with me at Circle. I’ll be able to see you quickly, meaning we can get to the bottom of what exactly is causing the problem. Where treatment is advised, I will talk you through your options so that you have the information you need to make an informed decision. Prompt treatment can help get you back to full strength again as soon as possible, so do contact Circle to book your visit with me.

I first noticed something wasn’t quite right with my shoulder when I found myself struggling to put on my coat; the shoulder just didn’t seem quite as mobile as normal and it was difficult to get my arm in the sleeve. It wasn’t too painful at first, so I ignored it and carried on with normal life.  

However, the problem continued to get worse, until eventually I was having to ask my wife to help me put on my shirts and coats. I just wasn’t able to move my left arm enough to put them on myself. I also started getting more pain in my shoulder, especially at night. In bed, I had to be careful to sleep on the correct side, so that I didn’t make the pain worse. 

As the pain and stiffness became worse (and more frustrating), I went online to do some research. Fortunately, I discovered a colleague of mine had suffered from a similar problem and had been treated successfully, so I got in touch with them. As soon I told them about my symptoms, they told me to see Andrew Chambler at Circle for help. 

By the time I met with Andrew, he had already looked at a previous MRI scan I’d had. We talked about my symptoms and he had a good examination of my shoulder. It turned out that the inside of my shoulder joint was inflamed, and this was causing all my pain and stiffness. I had what’s known as a ‘frozen shoulder’.   

We discussed the various treatment options available, and these were to basically leave it to clear up by itself, to have a cortisone injection into the joint to reduce the inflammation, or to have keyhole surgery. 

During our meeting, I had lots of questions for Andrew and he answered them all. He was very open and honest about everything, and there was no pressure put on me to make any decisions. Of the three potential treatment options we discussed, the one that seemed to make the best sense for me was keyhole surgery, so I decided to go ahead with that. 

Before the surgery, everything was explained to me very clearly, including what to expect when I woke up. I’m glad to say that the pain after the surgery was actually much less than I’d been expecting. It just felt like a dull thump in the arm, nothing more. My shoulder felt so much better straight away and I found that I didn’t need any painkillers.   

When I spoke with Andrew after the operation, he told me that on a scale of 1 – 10, with 1 being low, my shoulder inflammation was 8-9, so I had definitely needed the surgery. Seeing Andrew and having the surgery was absolutely the right call. I don’t have pain in my shoulder and am able to move it normally again. I cannot say enough good things about Andrew and the rest of the staff at Circle, I would not hesitate to recommend them.  

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020 3613 6779

Circle Bath Hospital, Foxcote Avenue, Peasedown St John, Bath BA2 8SQ

Good

Overall rating 24th April 2017