Do you ever experience shoulder pain and stiffness that restricts your range of motion? You might have what’s known as a frozen shoulder. Singaporean orthopaedic surgeon DR CHEW CHEE PING has trained under experts in Germany and specialises in shoulder, knee and arthroscopic sports surgery. With years of experience helping patients deal with frozen shoulder, he’s a great person to answer all our questions about it. Here, Dr Chew explains the causes, symptoms and medical treatment options available. Plus, we look at some physiotherapy exercises you can do at home.
Advice on managing a frozen shoulder
What exactly is frozen shoulder?
Also known as adhesive capsulitis, it’s a condition that affects the shoulder joint, causing pain, stiffness and limited mobility.
How does it come about?
It occurs when the tissues around the shoulder joint become inflamed and thickened, resulting in a tightening and stiffening of the joint capsule. While the exact cause of frozen shoulder is not fully understood, certain factors can increase the risk of developing the condition. These include age and gender, with women between the ages of 40 and 60 being more prone. Also, individuals with medical conditions like diabetes, cardiovascular disease, hypothyroidism and Parkinson’s disease are at a higher risk. Previous shoulder injuries, surgeries or prolonged immobility of the joint can also contribute.
How do you know if you’re suffering from frozen shoulder?
The main symptoms include worsening shoulder pain with movement, stiffness in the shoulder joint and decreased range of motion. Everyday activities like reaching, lifting and dressing can become challenging and painful. Discomfort may even disrupt sleep patterns, leading to a decreased quality of life. If this resonates with you, it’s time for a diagnosis from a shoulder specialist and to get started on frozen shoulder exercises!
How long does an episode typically last?
Frozen shoulder usually progresses through three stages: freezing, frozen and thawing. The freezing stage begins with gradual onset pain and stiffness in the shoulder, which worsens over time. Next, in the frozen stage, the shoulder becomes very stiff with a limited range of motion. Finally, the thawing stage occurs, where stiffness gradually subsides, and shoulder mobility improves. Each stage lasts from three to eight months, so it takes several months to a year or longer to fully recover.
What are the available treatments for a frozen shoulder?
Frozen shoulder treatment focuses on managing pain, improving range of motion, and restoring shoulder function. The approach varies depending on the severity and stage of the condition.
#1 Conservative management
In the early stages, conservative management is often recommended. Firstly, for pain management, non-steroidal anti-inflammatory drugs (NSAIDs) or pain relievers alleviate pain and reduce inflammation. Then, physical therapy involving regular stretching and strengthening exercises, along with a tailored exercise programme is crucial. This promotes healing, restores function and improves mobility, muscle strength and range of motion. Heat and cold therapy is also very effective. Applying heat relaxes muscles and increases blood flow, while cold therapy reduces inflammation and provides temporary pain relief.
If conservative measures don’t resolve the problem, corticosteroid injections directly into the shoulder joint are the next step. They can provide temporary relief, reduce inflammation, relieve pain and facilitate progress in physical therapy.
#3 Surgical interventions
In rare cases where conservative treatments and injections fail to improve symptoms, surgical options such as an arthroscopic “keyhole” release with manipulation under anaesthesia may be considered. These procedures aim to release the tightened joint capsule, improve range of motion and alleviate pain.
Frozen shoulder, although challenging, does not have to define your life, according to Dr Chew. With early medical intervention and a comprehensive treatment plan including physical therapy and exercises, it’s a condition you can manage and overcome.
What frozen shoulder exercises are there?
Supplementing professional treatment with at-home physiotherapy exercises can help with the recovery process and maintain shoulder mobility. According to the team at leading Singapore specialist rehabilitation group Urban Rehab, consistency, patience and persistence are key when it comes to frozen shoulder exercises!
Physiotherapy exercises to try
#1 Pendulum swings
Gently lean forward and let your arm hang down. Swing your arm in small circles, both clockwise and counterclockwise, to encourage shoulder movement.
#2 Wall crawls
Stand facing a wall and use your fingers to “crawl” up the wall, gradually extending your arm overhead. Repeat several times.
#3 Cross-body stretches
Use your unaffected arm to gently pull the affected arm across your body, stretching the shoulder muscles. Hold for 20 to 30 seconds and repeat on the other side.
#4 Towel stretches
Hold a towel with both hands behind your back, with one hand gripping the towel from above and the other from below. Slowly lift the towel upward, stretching the shoulder joint.
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This article first appeared in the September 2023 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy! To make the most of living in Singapore, read our latest City Guide here for free!
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