Frozen shoulder is caused by inflammation of the soft tissue around the shoulder joint. It is more common in females and in people aged over 50.

Cause

The actual cause of frozen shoulder is unknown, but it may be related to injury or overuse of the shoulder joint. Also, it may happen when movement of the shoulder is decreased, e.g. in people who suffer from stroke or have operation done around the shoulder joint.

Symptoms

In the early stage, shoulder pain develops gradually. The pain usually becomes more obvious at night that interferes with sleep, or the patient may feel painful when sleeping on the affected side. As pain lessens, the shoulder joint becomes stiff and the range of movement decreases. Hence, daily activities like putting on clothes, bathing and lifting objects may become difficult to the patient.

Treatment

• Application of hot pad can relieve the shoulder pain.
• Physiotherapy can relive pain and control the progress of the disease.
• Medications like painkillers are commonly used, but they should be used only after doctor's advice and with care.
• Appropriate exercise program and home care principles are other ways to reduce shoulder pain and maintain joint movement.

When the shoulder pain is severe:

1. Avoid using the affected side to lift heavy objects.
2. Avoid overuse of the same side. Use both shoulders alternatively.
3. Avoid twisting movement of the joint or sleeping on the affected side.
4. Avoid using the affected hand to do self-care activities. Some practical tips on self-care include the following:
   • Dressing: Start wearing clothes on the affected side first and then followed by the other side.
   • Bathing: When cleaning the back, a towel long enough to be grasped by hands at both ends should be used. Place the unaffected hand behind the neck while placing the other hand at the back. Then the unaffected hand pulls up the affected side to rub the back. Alternatively, use a long handle brush.
   • Combing: Use the unaffected hand or use a long handle comb instead.
   • Washing hair or face: Use the unaffected hand.
   • Chopping food: Use a lighter knife to avoid extra load on the shoulder. Use a mincer instead of chopping the meat.
5. Gentle mobilization exercise like "Pendular exercise" can be performed to improve circulation, relax muscle and relief pain. When performing the exercise, the hand should not carry any weight and the arm should move according to the level of pain.

When pain is relieved, but movement of shoulder is still restricted, we should:

• Use the affected side more and perform stretching exercise to decrease stiffness.
• Consult health professional for maintenance exercise.