Frozen shoulder treatment

What is frozen shoulder?

Having frozen shoulder means pain and reduced mobility in the shoulder. It is difficult to rotate and extend the arm outwards and to lift the arm and extend it upwards. These movements are also difficult to perform passively due to severe pain and stiffness. Passively means that someone else takes the arm and performs the movements.

Frozen shoulder is often insidious and it can be difficult to deduce a cause for the problem. The most common explanation is that it is idiopathic, i.e. without a known cause. Trauma, such as a fall on the shoulder, can also result in frozen shoulder. When, due to pain or injury, the shoulder is immobilized, mobility is reduced even more, the flow in the fascia is reduced and a constriction occurs. This increases the risk of the shoulder remaining immobile and stiff.

Phases of Frozen shoulder

The course of frozen shoulder is divided into three different phases. Initially, phase one is characterized by very severe pain in the shoulder, especially when you move it. Now you have inflammation in the shoulder joint and it can last from a few months up to six months. It causes difficulty sleeping, the shoulder is in constant pain and it is difficult to sleep as you cannot lie on your shoulder. The shoulder also becomes progressively stiffer, perhaps because you avoid moving it as it is so painful.

Phase two, now the inflammation and pain are decreasing but the shoulder has become stiffer and stiffer, the joint capsule has begun to thicken and also shrink, as mobility decreases. This goes on for another six months.

Phase three is also called the healing phase, which can last a year or more. By now, the joint capsule has thickened and strengthened with more collagen. Mobility slowly starts to return, but full mobility is rarely regained and you have to live with a reduced range of motion and some pain may also remain, chronically.

Frozen shoulder is usually measured in ‘range of motion’, to examine its mobility, by measuring how many degrees the person can lift the arm sideways, upwards. When you are not in too much pain and can cope with everyday life, you get used to living with these limitations.

Frozen shoulder symptoms?

The first symptoms of frozen shoulder problems are pain when moving the arm, especially when lifting it outwards and upwards. Even when someone helps to move the arm, it becomes difficult because of the pain. As a result, certain movements are avoided and mobility is limited. After a few months, the shoulder starts to stiffen, making it difficult to do everyday tasks such as cooking, combing your hair, showering or using deodorant. Now the shoulder becomes stiffer and you may have more persistent pain. Frozen shoulder also often causes difficulty sleeping, as the pain in the shoulder makes it difficult to assume different sleeping positions and thus affects sleep.

What causes frozen shoulder?

Most often, the cause of frozen shoulder cannot be determined. However, there is a clear correlation between unilateral movements over a long period and unilateral strain over a long period. Different occupational categories can be affected, such as manual workers and office workers. More women than men are affected and usually between the ages of 40 and 60. There is also a higher risk of being affected if you are diabetic, which means you have high blood sugar levels. It is known that fascia and connective tissue are negatively affected by high blood sugar, as caramelized sugar is stored in the connective tissue. The connective tissue then becomes brittle and inelastic and loses mobility. Diet and lifestyle could therefore affect and cause frozen shoulder as stress also causes high blood sugar levels.

Often frozen shoulder occurs as a result of the shoulder or arm being misused and constantly overworked. It has been seen that right-handed people are often affected in the left shoulder and vice versa, which may indicate that the left (in the right-handed case) is weaker and more untrained for the work being done. As the shoulder then becomes inflamed due to the overuse and starts to hurt, people avoid moving it as much as possible, the immobilization causes the flow in the fascia to constrict, the joint capsule to thicken (shrink) as the body tries to strengthen the joint. Eventually, mobility decreases even more and the shoulder stiffens.

How do you treat frozen shoulder?

There are two types of conventional treatment that can be taken in the healthcare setting. One is cortisone injection. However, many studies show that cortisone treatment does not work at all, it only relieves pain and is anti-inflammatory. Rather, it is a temporary solution that removes symptoms. Injecting cortisone into the joint can also have negative consequences, as repeated cortisone treatments have a degrading effect on the body’s tissues. It can lead to the breakdown of articular cartilage and joint capsule and can thus cause worse problems in the long run.

The other traditional treatment is surgery, but again, most studies show that surgery is ineffective as it does not prevent or address the root cause. In addition, there is a risk of scarring and a number of other problems, as the shoulder joint is a very complicated and narrow joint where nerves are easily pinched. There has not been a clinically proven treatment for frozen shoulder, until 2019 when a research study on fascia treatment with vibration was done and discovered that mobility can be increased with mechanical fascia treatment. There are many treatment methods, such as chiropractic and manual, which have helped patients with frozen shoulder in the past. Fascia treatment methods have been researched and developed to address frozen shoulder. There are hundreds of case studies of successful treatments. So treatment for frozen shoulder should be tested at Fascia Clinics before deciding on cortisone treatment or surgery.

Does an exercise program for frozen shoulder help?

Exercise programs help with frozen shoulder in that they try to force movement with the arm. Performing light movements, without overexerting, reduces the risk of shoulder stiffness leading to even less mobility. However, active movement can be difficult as muscles atrophy. In this case, it is better to move the arm passively through exercises such as climbing with your fingers on the wall because it is then easier to get the arm up by forcing it up. Here it is also important to feel the pain threshold so that it does not hurt too much. Different exercise programs help the shoulder to gradually improve mobility and reduce pain, although it does not remove the underlying problem.

Lie on your back with your legs on a stool, with your hips and legs at a 90° angle, extend your arms away from your body with your palms facing up. Relax and breathe deeply, lie like this for 10 minutes and feel how your shoulders and back come deeper towards the ground.

Relaxation exercises with deep breathing is very valuable. Deep breathing through the nose, slowly down to three breaths per minute, with a deep inhalation so that the diaphragm gets as deep as possible, has a very great effect. Several times a day for periods of about 10 minutes.

Frozen shoulder massage

Exercises and manual treatments are the predominant and better options. It is possible to soften the muscles with traditional massage and anything that increases circulation and flow can provide relief. Fascia Clinics has conducted a study on a vibration treatment method that actually works, using the Swedish Fascia Vibes treatment machine that provides deep massage with gentle oscillating vibrations in a sine wave. It does not strike or hammer the tissue, as other massage guns do.

The study showed that 87% of patients gained more than 30° of increased mobility and 40% achieved full mobility after three treatments and more than half gained more than 60° of increased mobility. 70% had improved sleep. The study shows that treatment at Fascia Clinics can be an effective treatment for frozen shoulder.

Frozen shoulder pain relief – what can you do?

Painkillers help to relieve the pain. You can get cortisone from your healthcare provider to relieve pain in the area. However, it should be borne in mind that cortisone can complicate and prolong the healing process by breaking down tissue. Instead, trying a fascia treatment at the Fascia Clinics for pain relief and also increased mobility can give good results and definitely has no harmful side effects.

It is important to maintain good circulation and mobility in the shoulder. Sauna or hot baths can help and provide temporary relief to facilitate movement. Relaxation exercises and deep breathing are always good.