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Frozen Shoulder

Patients presenting with frozen shoulder will often report an insidious onset with a progressive increase in pain, and a gradual decrease in active and passive range of motion.

One of the main presenting factors is loss of external rotation in a dependent position with the arm down by the side.

Patients frequently have difficulty with grooming, performing overhead activities, dressing, and particularly fastening items behind the back. Frozen shoulder is considered to be a self-limiting disease with sources stating symptom resolution as early as 6 months up to 11 years.

Frozen shoulder progresses through three overlapping clinical phases:

Frozen shoulder
Frozen shoulder

  • Acute/freezing/painful phase: Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption which may last anywhere from 2-9 months.

  • Adhesive/frozen/stiffening phase: Pain starts to subside, progressive loss of GH motion in capsular pattern. Pain is apparent only at extremes of movement. This phase may occur at around 4 months and last till about 12 months.

  • Resolution/thawing phase: Spontaneous, progressive improvement in functional range of motion which can last anywhere from 5 to 24 months. Despite this, some studies suggest that it's a self limiting condition, and may last up to three years. Though other studies have shown that up to 40% of patients may have persistent symptoms and restriction of movement beyond three years. It is estimated that 15% may have persistent pain and long term disability. Effective treatments which shorten the duration of the symptoms and disability will have a significant value on reducing the morbidity.

Physiotherapy helps to restore movement and regain faction of the shoulder helping you to improve ability with your daily activities.


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