There are a multitude of causes for frozen shoulder and no known instant cure. By cause I do not mean the initial action which was painful, I mean the damage and responses within the joint and surrounding soft tissues.
The main thing about Frozen shoulder is never leave it; the sooner it is treated then the greater chance the therapist has of controlling it. I nearly said clearing it but that would be over confidence, treating this particular problem has a very uncertain outcome. Maintaining it at a reasonable level of discomfort and restriction is normally possible.
There are a multitude of causes for frozen shoulder and no known instant cure.
The name tells what happens if it is left untreated. Generally slowly but occasionally instantly, all movement at the shoulder is lost. The condition is normally extremely painful, interrupting sleep also restricting movement at the elbow and weakening the grip.
For those under eighty the condition normally self corrects after about three years but for a few, and most over eighties, it never does. Unfortunately it has a nasty aftermath in some. In about one third of cases as the first shoulder recovers, the second develops the problem. Remembering that the key to recovery is prompt action see your therapist quickly.
The first indications of frozen shoulder are pain at the shoulder. This can be either when reaching for something above the head, like doing your hair or for something behind your back as on the back seat of the car, or doing up a bra. This is due to two muscles that penetrate the joint capsule, one does each job.
Due to the interconnection of muscles this problem can be related to low back pains and to neck pains as well as pins and needles and numbness in the forearm and hand. The muscles of the arm will take this problem down to the elbow and forearm, producing spasms pain and weakness. Often there will be some carpel tunnel syndrome or R.S.I. as well.
With frozen shoulder the main rule is if it hurts to do it, then don’t do it.
The only exception to this rule is at the end, when all that is left is a single point of pain which only hurts occasionally, then, if you are only doing something once, go for it. If reaching for your hat then just push through the pain because at some point that restriction will tear free. But if you are painting the wall (or any other repeated action) and it starts to hurt then stop immediately.
Treatment is ‘slow contrast bathing’ at the shoulder this is because the worst of the inflammation is deep within the joint. Generally unfortunately this is at the lower point in the joint shown and the cold and warm have to go right up into the armpit.
There are no nerves within the joint capsule.
This is so counter intuitive that it needs explaining. You can feel the pain in the shoulder that is why you are seeking help. The truth is that all the pain that is felt is in the tissues around the joint and this can involve muscles, bursae and nerves all of which will report high levels of pain but none of them from within the joint.
So it is very easy to aggravate this deep inflammation without pain and so without being aware of doing it. This is why it seems to persist and fails to improve despite great care being taken not to work through pain.
Particularly this is true when the joint hasn’t been moved for awhile, as when you’ve been asleep, imagine how stuck fast that deep cartilage is after eight hours with the weight of the shoulders pushing it into the mattress without moving.
Start by tensing the muscles around the joint squeezing the fluid into the depths of the joint. Don’t move the arm yet. Lots of squeezes first.
Then gently rotate the upper arm a little this way and that, circle it gently and try to splash the synovial fluid that is contained within the capsule over the working surfaces to lubricate them before any load is put through the joint.
There is also inflammation on one or both, of two tendons that penetrate the joint capsule these and their muscles are responsible for most of the restriction. They too will appreciate small unloaded movements after rest. They will only require the normal contrast bathing.
This also shows why the pain is so great, so many nerves pass between the shoulder joint and the joints between the bone and cartilage part of the ribs which invariable become misaligned and when this inflames the adjacent tissues, including the nerves, pains extend down the arm and up into the neck.
Use anti-inflammatories at any time of day but pain killers only when rest or sleep is planned.
To find out which are pain killers and which anti inflammatories and when & how to use them go to ‘Using Pain Killers’
Also look on Contrast Bathing. the application of this is going to be helpful but remember you also need to See Your Therapist. preferably me.
From a Therapist’s point of view we may feel that we have completed treatment while you are still getting pain from the shoulder. The reason for this is that we have stopped the progress and reversed it but that there is still some adhesion at depth between tissues. These will clear in time but it may be a very long time during which the occasional movement will tear at it and that can be quite a savage instant pain. Again the most likely method of clearing this is deep contrast bathing [ie. the longer warm and cool sessions.]
One other thing about frozen shoulder is never leave it, the sooner it is treated then the greater chance the therapist has of clearing it.
These Injuries will cause pain in the affected forearm, often this is in both since, as pain develops in one arm, we start to use the other hand for those jobs which hurt and so develop the problem in both arms at once. They can cause stiffness, pain, pins & needles, numbness, swelling in the forearm, the shoulder and the neck. In the hand a loss of strength and dexterity are common symptoms. In severe cases the hand may at times develop black patches and the pain is often so severe that the patient cannot sleep.
To relieve this problem is far from simple and a Therapist’s speedy intervention is very advisable
Contrast bathing (Q.V.) is helpful but here the problems are so deep that it is advisable to extend the warm and cool periods by at least double, so two minutes warm and four minutes cool.
See Your Therapist, preferably me