Frozen Shoulder: Understanding the Thawing Process and How Osteopathy Can Help
Frozen shoulder, clinically known as adhesive capsulitis, is a condition characterised by the progressive stiffening and painful loss of movement in the shoulder joint. It can be a frustrating and debilitating experience, making simple tasks like reaching for a seatbelt or brushing your hair incredibly difficult.
Understanding the nature of this condition is the first step toward managing it effectively. Osteopathy offers a gentle, holistic approach to support your body through the different stages of frozen shoulder, helping to manage pain and work towards restoring your range of motion.
Key Facts About Frozen Shoulder
A Specific Condition: Frozen shoulder involves the inflammation and thickening of the shoulder joint's capsule, a connective tissue envelope that surrounds the joint, causing it to "tighten."
Phased Progression: It typically progresses through three overlapping stages: freezing (painful), frozen (stiff), and thawing (resolution). The entire process can last from 1 to 3 years.
Risk Factors: It most commonly affects people between 40 and 60, is more frequent in women, and is associated with certain systemic conditions like diabetes and thyroid disorders.
Common Causes and Types of Frozen Shoulder
The exact cause is not fully understood, but it is classified into two main types:
Primary (Idiopathic) Frozen Shoulder: This is the most common type, where there is no known precipitating injury or cause. It often arises spontaneously.
Secondary Frozen Shoulder: This develops after a shoulder injury (like a fracture or rotator cuff tear), surgery, or a period of immobility where the shoulder has not been moved through its full range.
Certain systemic health conditions, including diabetes, thyroid disorders, cardiovascular disease, and Parkinson's disease, are known to increase the risk of developing a frozen shoulder.
The Typical Stages of Frozen Shoulder
Freezing Stage (Painful Stage):
Duration: 2-9 months
Symptoms: Gradual onset of pain, which often worsens at night. A progressive loss of range of motion begins as the pain increases.
Frozen Stage (Stiff Stage):
Duration: 4-12 months
Symptoms: The pain may begin to lessen, but the stiffness becomes more significant. The shoulder becomes very difficult to move in all directions.
Thawing Stage (Resolution Stage):
Duration: 5-24 months
Symptoms: The range of motion slowly begins to return.
How Can Osteopathy Help with Frozen Shoulder?
Osteopathic management for frozen shoulder is tailored to the specific stage of the condition. The goal is not to force the joint, but to work with the body to manage symptoms, maintain as much function as possible, and support the natural recovery process.
During your initial consultation, we will:
Take a detailed history to understand the onset of your symptoms, your pain patterns, and any relevant medical history.
Perform a thorough physical examination to assess your shoulder's active and passive range of motion and identify the specific movement restrictions.
Conduct a postural and biomechanical assessment of your neck and upper back, as tension here can influence shoulder function and pain.
What Does Osteopathic Treatment Involve?
Treatment is always gentle and respectful of your pain levels. It may include:
Pain Management: In the painful 'freezing' stage, the focus is on gentle techniques to alleviate pain. This includes soft tissue massage to the surrounding neck, upper back, and shoulder blade muscles, and very gentle mobilisation of the neck and upper back to reduce nerve irritation and muscle guarding.
Maintaining Mobility: Throughout all stages, we use gentle, rhythmic articulation techniques to help maintain available joint play in the shoulder, without aggravating the inflamed capsule.
Addressing Compensatory Patterns: We treat the secondary issues that arise from a frozen shoulder, such as muscle tension in the neck and opposite shoulder, which are working harder to compensate.
Providing Personalised Advice and Rehabilitation: You will receive guidance on:
Pain-free Pendulum Exercises: To gently encourage movement without strain.
Postural Advice: To reduce stress on the shoulder girdle during daily activities.
Heat Therapy: To help relax surrounding muscles before gentle stretching.
A Progressive Home Exercise Program: Tailored to your specific stage of recovery to help gradually restore range of motion and strength as the joint "thaws."
When to Seek Further Medical Help
A proper diagnosis is essential. Please consult your GP for an accurate diagnosis and to rule out other conditions. It is particularly important to see your GP if:
Your shoulder pain is the result of a significant injury or trauma.
You experience severe, unremitting pain, especially at night.
You notice significant swelling, redness, or warmth in the joint, which could indicate an infection or other inflammatory condition.
You have an underlying health condition like diabetes, as this requires coordinated management.
Your GP can confirm the diagnosis and may discuss other management options, such as a referral for imaging or a corticosteroid injection, which can sometimes be used in conjunction with manual therapy to manage pain in the early stages.
Support Your Shoulder's Recovery Journey
While frozen shoulder can be a long and challenging condition, you don't have to go through it alone. Osteopathy can provide supportive, hands-on care throughout the different stages, helping you manage discomfort and work towards regaining your mobility.
Click here to schedule an appointment with one of our experienced osteopaths. Let us develop a personalised plan to support your recovery.
References
*Kelley, M. J., Shaffer, M. A., Kuhn, J. E., Michener, L. A., Seitz, A. L., Uhl, T. L., ... & Stokes, J. (2013). Shoulder pain and mobility deficits: adhesive capsulitis. Journal of Orthopaedic & Sports Physical Therapy, 43(5), A1-A31. [Link: https://www.jospt.org/doi/10.2519/jospt.2013.0302]*
*Manske, R. C., & Prohaska, D. (2008). Diagnosis and management of adhesive capsulitis. Current Reviews in Musculoskeletal Medicine, 1(3-4), 180–189. [Link: https://link.springer.com/article/10.1007/s12178-008-9031-6]*
The Royal Australian College of General Practitioners (RACGP). (2015). Shoulder pain. [Link: https://www.racgp.org.au/afp/2015/september/shoulder-pain/]
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on the best available evidence at the time of publication but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition, the stage of their frozen shoulder, and their response to care. Osteopathic care is a complementary approach and works alongside medical management.