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Chiropractic Treatment for Adhesive Capsulitis or Frozen Shoulder
What is Adhesive Capsulitis or Frozen Shoulder?
The cause of frozen shoulder is unknown. It is thought that adhesions develop between or within the capsule of the shoulder. The process begins as an inflammatory process that resolves with fibrosis. There are three stages of frozen shoulder:
- The acute inflammatory Stage. This stage can be very painful, and all shoulder movements are painful. The pain can be disabling and normally interferes with sleep. This phase can last 1-9 months. The pain can be made worse by psychological stress and exposure to cold.
- The stiffening Stage. This stage is less painful, but lifting the arm and turning it out is severely restricted. This phase can last 4-12months.
- Thawing Phase. This phase is a recovery phase where the range of motion is gradually restored, and can last several months to years. About 60% of individuals are left with some permanent loss of shoulder motion.
In most cases, the patient cannot recall any specific event that triggered the pain. Frozen shoulder is more common in people who have diabetes, hyperthyroidism, chronic obstructive or other lung diseases, and those who have had a heart attack. Frozen shoulder might also affect those who have suffered trauma to the shoulder, for example a fracture to the humerus. Adhesive Capsulitis Treatment? Treatment for Frozen Shoulder depends what phase the process is in.
The Acute Phase
- Sleep on the non-affected side with painful shoulder supported by a pillow.
- Pain relief medication is needed. Talk to your doctor about NSAID’s. TENS may help with the pain.
- Use gentle passive stretching exercises, e.g. Codman’s exercises and mild strengthening isometric exercises (see video for demonstration.)
The Stiffening and Thawing Phase
- Continue pain relief medication. Review medication with your GP.
- See a chiropractor for gentle hands-on treatment to mobilise the shoulder and improve surrounding joint and soft tissue function.
- Ultrasound may help.
- Continue stretching regularly every day. Use a heat pack prior to stretching for additional stretch. An ice-pack after stretching might be beneficial should you find stretching painful. Always work within your pain tolerance. Do not overdo it. “Wall-walking exercises” are good (see video for demonstration.) Hold-Relax techniques are also effective to help regain normal glenohumeral motion. Your chiropractor can help show you how to do these.
Will I need to have Surgery for Adhesive Capsulitis?
If, after three months you are not responding to pain medication and treatment then a corticosteroid injection with anaesthetic may be beneficial for the short-term. A referral to a surgeon for manipulation under anaesthetic is another option. Adhesive capsulitis also can be treated surgically by cutting the capsule (capsular release). This is most commonly done using an arthroscope, although arthroscopy is difficult in adhesive capsulitis due to the contracted capsule and small joint volume. Open capsular release also can be performed, although this is rarely indicated since the natural history of adhesive capsulitis is one of progressive improvement. Individuals with diabetes often do not benefit from manipulation and more commonly require surgery if therapy fails.
If you would like to know more about frozen shoulder, ring Soonius Chiropractic on 07855 822 538 for professional, friendly advice.