Frozen shoulder usually starts as an ache in the shoulder but then develops into an increasingly intrusive pain. It's manageable most of the time, but if you make a sudden sharp movement, like swatting a fly or trying to catch something that falls out of the fridge, you will get an absolutely horrible pain. Sharp movements are spectacularly painful, and that is the key thing I look out for in the medical history of somebody with frozen shoulder.
Over time, it will become a constant, dull ache in the shoulder, and even small things like jogging can make the pain worse. People also begin to lose their ability to carry out certain movements. This then increases the problem, as it's not just pain that's stopping the movement, there is actually a physical restriction to their range of movement. For women, this may mean that they are no longer able to get their hand up to reach their bra. Men may find they are not able to thread their belt or reach their back pocket.
Night pain is also a very common feature of frozen shoulder, and this can have a real effect on the quality of life.
In terms of treating a frozen shoulder, there are three main options; waiting, pain-relieving injection or manipulation under anaesthetic (MUA). Some people also may try physiotherapy, although most will usually find it too painful and stop fairly quickly.
- Natural resolution: I always say that if we abandoned you on a desert island with a frozen shoulder and then came back again in 18 months, your arm would be normal, you'd have no more pain, you would have full movement and your shoulder would work perfectly for the rest of your life. However (and this is a significant disadvantage), this can be very slow, taking anywhere between 12-18 months. While some people may be okay choosing this option, many people prefer to be more proactive in their treatment.
- Cortisone injection: If somebody would rather not wait 12-18 months for a natural resolution, the next step would be for them to have a cortisone injection into the middle of their shoulder joint. In my experience, this is best done using ultrasound to make sure that it goes in at exactly the right position. A cortisone injection is very effective for relieving pain. It can sometimes take a week or so to have full effect, and although it takes the pain away, your shoulder will still be tight. For many people, this is the right treatment option; their horrible, sharp pains will settle, their constant low background pain will go, and their nights will be better. Although they will still be tight, they can manage the tightness if they know that it will get better eventually. The key thing for most people is to stop the pain.
- Manipulation under anaesthetic MUA): For a smaller proportion of people, the lack of movement is really the most significant problem. This may be interfering with their work, their sports, or they just want the whole thing to go away as quickly as possible. In these cases, we do a minor operation called a ‘manipulation under anesthetic’ in which we stretch the shoulder and give an injection into the shoulder while you're asleep under a general anaesthetic. As simple as it sounds, this recovers all the movement in the shoulder. It will take about 4 weeks for you to fully recover and you will need to do a lot of physiotherapy, but after that your shoulder will be fully back to normal again.
If you are struggling with a frozen shoulder, or any other shoulder problem, why not arrange a consultation with me? I will carry out a comprehensive examination of your shoulder, and if any treatment is needed, I can talk you through the different options so that you have all the information you need to make an informed decision. At Circle, you can see me quickly, meaning I can help get you treated and back to full strength and activity again as soon as possible.
I exercise twice a day, usually with a combination of running, yoga or Pilates. I keep log of my exercise so that I can see my progress. This is how I knew I had an injury; I remember logging down that my shoulder was hurting. At first, I thought it was probably just delayed onset muscle soreness (DOMS), so I kept on exercising through the pain.
I then fell on holiday, and my shoulder was still hurting when I came home, so I called my private health provider who referred me for 6-8 weeks of physiotherapy. Whilst I saw some improvement, on days immediately after the physiotherapy the pain was actually getting worse. It was actually my physiotherapist who recommended Harry Brownlow to me. I called my private health provider and they gave my two surgeons who were on their approved list. Harry was one of them, and as I’d heard good things about him from other people, I chose to see him.
When I went for my initial consultation, my movements were incredibly restricted. While I was still running, it wasn’t comfortable. I was also still doing yoga and Pilates but was having to restrict them to lower body exercises rather than the top half of my body because I couldn’t lie on one side. It was also beginning to interrupt my sleep pattern, and I was waking up numb down one side.
Harry was brilliant. He immediately diagnosed frozen shoulder, and then did an ultrasound to confirm. He talked me through my treatment options, which were to do nothing, to have an injection or to have a manipulation under anaesthetic.
There was no pressure at all put on me to decide there and then, and I could have gone away to consider the options. However, I couldn’t see any point in waiting as the problem was just so restrictive to my lifestyle. I chose to have the manipulation under anaesthetic.
When I went in for it a few days later, I had the procedure done around lunchtime and was then home by 4pm! It was so quick.
The physio came to see me before I was discharged with a list of exercises to do. I did them religiously and my shoulder is vastly improved from what it was. I don’t have any pain at all. While it isn’t yet perfect, it is improving every week - it’s just a slow process.
Harry was very reassuring from the very beginning, which made my choice easy. I had already made the decision before I even entered the room that if he suggested surgery as a treatment option, I would take it. I know that if I had wanted to delay, or to go away and have a think about it, he would have been incredibly patient with me. I am so pleased I chose to have Harry treat me.
- Elbow arthroscopy
- Rotator cuff surgery
- Shoulder arthroscopic release
- Shoulder arthroscopic decompression
- Shoulder stabilisation (Bankart repair)
- Shoulder replacement surgery
- Tennis elbow treatment
- Ulnar nerve release surgery
- Diagnostic ultrasound
- Elbow open debridement (elbow arthritis)
- Elbow ligament injuries
- Biceps tendon pain
- Biceps tendon tear
- Biceps tendonitis
- AC joint repairs
- Labral tear in the shoulder
- Reverse shoulder replacement
- Shoulder dislocation
- Frozen shoulder