Frozen Shoulder Treatment and Prevention

Frozen shoulder causes stiffness and pain in the shoulder joint, with symptoms worsening over time. Symptoms of pain and stiffness generally go away within 3 years. It is suggested that approximately 5% of the population will experience a frozen shoulder within their lifetime. Frozen shoulders are most common amongst people between the ages of 40 and 60. In addition, women are more prone to developing frozen shoulder in comparison to males. Diabetic patients are at an increased risk of developing a frozen shoulder.

Frozen Shoulder in Singapore

Sometimes referred to as the ‘50-year shoulder’ in Chinese, frozen shoulder is a common condition in Singapore. Considering our ageing population, it makes sense that the condition is common amongst Singaporeans since it is most prevalent amongst the older generation. Diabetic patients are also at a higher risk of developing frozen shoulder and diabetes is one of the most common chronic diseases in Singapore.

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What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, refers to a condition in which the shoulder joint experiences a loss of motion, stiffness and pain. The pain and stiffness get worse over time, before finally going away after a long time. The pain and stiffness can last up to 3 years. The pain and stiffness are the results of your shoulder capsule becoming increasingly thick and tight, to the extent in which the shoulder becomes difficult to move. The shoulder capsule refers to the tissue in your shoulder that holds the upper arm (humerus), shoulder blade (scapula), and the collarbone (clavicle) together. The stiffness and pain can be further aggravated by the formation of scar tissue and a lack of lubrication due to insufficient synovial fluid. While frozen shoulders rarely reoccur in the same shoulder after it has gone away, some people may experience a reoccurrence in the other shoulder.

Symptoms of Frozen Shoulder

Frozen shoulder typically develops in 3 stages, each with its own timeline and symptoms. However, these are some of the symptoms of a frozen shoulder in general:

Dull or achy pain in one shoulder
Difficulty moving or inability to move the shoulder
Pain in the shoulder muscles that wrap around the top of your arm

Stages of Frozen Shoulder

Freezing Stage. In the freezing stage, you experience pain when attempting to move your shoulder, which worsens over time. A loss in the range of motion of the affected shoulder is experienced. The pain may be worse at night. This stage can last from 2 to 9 months.

Frozen Stage. In the frozen stage, you may experience less pain than before, but the stiffness of the shoulder gets worse, to the point where it is difficult for you to carry out your daily activities. This stage can last from 4 to 12 months.

Thawing Stage. In the thawing stage, the shoulder regains its mobility slowly. This stage can last from 6 months to 2 years.

Risk Factors of Frozen Shoulder

Risk factors of a frozen shoulder include:

Age. Those between 40 to 60 are at an increased risk of developing a frozen shoulder.
Sex. Women are more susceptible to developing frozen shoulder in comparison to men.
Inability to move your shoulder frequently. Certain conditions may prevent you from being able to move your shoulders frequently. For example, if you are recovering from a stroke, you might not be able to move your shoulder much. Keeping your shoulder in a fixed position for prolonged periods of time will increase your risk of developing a frozen shoulder.
Medical conditions. Certain medical conditions increase your risk of developing a frozen shoulder. These may include diabetes, heart disease, thyroid disease, and Parkinson disease.

Complications of Frozen Shoulder

Shoulder pains
Loss of mobility
Reduced range of motion
Long-term muscle problems that may worsen
Complete immobilisation

It is best to seek treatment early so that you can speed up your shoulder’s recovery process and avoid unwanted complications.

Diagnosing Frozen Shoulder

To diagnose a frozen shoulder, your healthcare provider may conduct a physical examination to check for your active range of motion and passive range of motion. This is done by checking for pain while you move your arm and checking the range of movement of your arm while relaxed. Should it be necessary, your doctor may also suggest imaging tests such as an X-ray or an MRI (Magnetic Resonance Imaging) test in order to rule out other possible health conditions that may be affecting your shoulder.

Preventing Frozen Shoulder

Recovering from a frozen shoulder is a long process that may take up to 3 years. It is ideal to avoid developing a frozen shoulder in the first place via preventive measures. These may include:

Regular stretching of your shoulders and back muscles
Regular stretching of your tendons
Practice good ergonomics, especially when using a computer or sitting at a desk for prolonged periods of time
Maintaining a healthy immune system
If you are recovering from an injury or surgery, practicing range-of-motion exercises can be crucial in preventing a potential frozen shoulder
Monitoring your diabetic condition, if you are diabetic

Frozen Shoulder Treatment

Treatment methods for a frozen shoulder typically aim to reduce inflammation and pain, as well as to increase the range of motion of the affected shoulder.

Medication

Anti-inflammatory medication. Anti-inflammatory medication such as ibuprofen can be prescribed to relieve pain and inflammation in the affected shoulder.

Corticosteroid. Corticosteroids may be injected into the affected shoulder joint, relieving pain and improving your range of motion.

Physiotherapy for Frozen Shoulder

Physiotherapy is effective in relieving pain and recovering range-of-motion loss due to a frozen shoulder. The types of exercises suitable for the patient will depend on their symptoms as well as stage of condition. Physiotherapy can also be used in conjuncture with anti-inflammatory medication, with studies highlighting higher efficacy when used together. A professional physiotherapist will be able to assess your condition and prescribe exercises that are best suited for your recovery process.

Manual Therapy and Exercises

Range-of-motion exercises may be prescribed with the objective of maintaining range-of-motion in the affected shoulder, which also helps with pain relief. This is especially effective in the freezing stage. Stretching exercises are vital in recovering the mobility of your affected shoulder as well as improving the flexibility of the muscles around the shoulder joint, which will be helpful in preventing recurrences. Strengthening exercises that target the shoulders as well as the core may be prescribed. These help to recover muscle strength after a period of immobility or reduced movement, as well as improve your overall posture which may be helpful in preventing future recurrences.

Hot and Cold Therapy

Heat and ice treatments may be used to relax your muscles prior to other forms of treatment.

Ultrasound Therapy

Ultrasound therapy can alleviate frozen shoulder pain, reduce inflammation, heal tissue, and improve range of motion.

TENS Therapy

Transcutaneous Electrical Nerve Stimulation can relieve frozen shoulder pain, relax shoulder muscles, and improve shoulder mobility.

TCM for Frozen Shoulder

In Traditional Chinese Medicine (TCM), frozen shoulder is seen as a disturbance in the body's energy flow. Through techniques like acupuncture and herbal medicine, TCM aims to restore balance, reduce pain, and improve mobility in the affected shoulder joint.

TCM Acupuncture

Acupuncture involves the insertion of thin needles into specific acupuncture points along the meridians of the body to stimulate Qi (vital energy) flow and promote healing. Acupuncture can help alleviate pain, reduce inflammation, and improve range of motion in individuals with frozen shoulder.

TCM Herbal Medicine

TCM herbal remedies are prescribed based on individual patterns of disharmony to address the root causes of frozen shoulder and alleviate symptoms such as pain and stiffness. Herbal formulas may include herbs with anti-inflammatory, analgesic, and muscle-relaxing properties to support healing and restore balance to the body.

TCM Cupping Therapy

Cupping therapy involves placing cups on the skin to create suction, which helps increase blood flow, reduce muscle tension, and promote healing. Cupping therapy can be effective in relieving pain and stiffness associated with frozen shoulder, particularly when applied to acupuncture points and meridians related to the shoulder area.

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No warranties or representations are given in respect of the medical information. Regis Wellness, Regis Wellness’s staff, and the website's operator will not be held liable if a user suffers any injury or loss after relying upon the medical information on this website.

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