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Complaining about pain in the shoulder editedAre you experiencing severe stiffness and pain in your shoulder? Maybe you feel that your shoulder movement has become so limited that it can't move without causing you pain?

If so, then you may have frozen shoulder syndrome.

Also known as adhesive capsulitis, it is a disorder that limits movement in the shoulder joint. It commonly affects patients around 50, hence the Chinese phrase "50-year shoulder." In Singapore, this is one of the most common types of shoulder pain.

Find out more about frozen shoulder syndrome and the best way to treat it!

Symptoms of Frozen Shoulder

Firstly, let's look at how adhesive capsulitis affects the shoulder.

The ball-and-socket joint of the shoulder is made up of three bones. These bones are held together by tissue, which forms the shoulder capsule. Usually, the shoulder joint is one of the most mobile joints in our body. However, even the slightest movement can cause shoulder pain when the capsule becomes inflamed.

Frozen shoulder is a chronic inflammatory condition. As a result of inflammation and scarring of the surrounding shoulder capsule, the ball-and-socket joint in the affected shoulder gradually loses mobility until it becomes "frozen."

Frozen shoulders severely restrict your range of motion, making even ordinary daily tasks like getting dressed or reaching for something challenging, as any movement can cause severe agony. This pain discourages further movement, and the lack of use worsens your condition.

Frozen shoulders make up 16-22% of all shoulder conditions, and 40-50% of these patients have it bilaterally. Hence, it can be a very debilitating time for patients when all you want is to carry on with your day to day life.


Stages of Frozen Shoulder

Frozen shoulder usually advances in three distinct stages, with the duration of each phase depending on the therapy treatments implemented.

1. The Freezing Stage

  • Early inflammation in the shoulder capsule
  • Your shoulder starts to get a little stiff with increasing pain as this stage progress.
  • This stage lasts for 6 to 9 months.

2. The Frozen Stage

  • Thickened synovium (a connective tissue that lines the inside of the joint capsule) due to increased inflammation
  • This will increase the growth of the adhesion in the capsule, increasing shoulder pain and decreasing range of motion in all directions, making sleep difficult and harder to carry out daily activities.
  • This stage can last for 4 to 12 months.

3. The Thawing Stage

  • As the inflammation decrease, there is reduced pain in your affected shoulder, and the shoulder range of motion begins to improve.
  • Returning to a full range of shoulder movements can take as little as 6 months or as much as 2 years.
  • This may not necessarily happen - some patients do not recover at all.

Frozen Shoulder Causes

It is still unclear why frozen shoulder occurs. However, there are certain risk factors:

  • Age and sex: Adults older than 40, especially women, are more likely to develop this condition.
  • Reduced mobility: People who have had prolonged immobility or reduced shoulder joint movement have higher risks for adhesive capsulitis. This may result from certain conditions, such as stroke or recovery from surgery.
  • Systemic diseases: Diabetes mellitus, hyperthyroidism, and Parkinson's disease increase the chances of developing this syndrome.

Other causes include:

  • poor alignment of the ball and socket joint
  • shoulder injury, such as a rotator cuff tear
  • injury to the shoulder muscles and soft tissue
  • injury to nearby spinal segments
  • long term postural issues
  • prolonged muscle guarding and/ or disuse
  • a pattern of repetitive stress on the shoulder, arm or upper back

Diagnosis of Frozen Shoulder

diagnosing a frozen shoulder

Aches, pain and stiffness of your shoulder may, in some cases, actually develop due to abnormal function or alignment in other parts of the body. For example, vertebral joint problems can cause spasms of the connective tissue, disturbing the coordination of arm-shoulder blade-neck-upper back movement.

In order to fully understand your condition, your Elite Spine chiropractor will conduct a thorough physical examination.

First, a few diagnostic tests are done, including:

  • postural assessment
  • shoulder motion, especially external rotation and internal rotation
  • the functional motion of the arms, neck (cervical) and upper back (scapulothoracic) to determine the presence of any biomechanical issues *

Imaging relevant structures may be required to accurately diagnose and rule out other underlying causes.

Typically, patients with frozen shoulders often present with other secondary problems. Issues such as neck and trapezius pain or tightness, postural abnormalities, headaches, and others, will be noted down as well.

Our thoroughness enables us to devise a comprehensive treatment strategy tailored to your needs.

Chiropractic Treatment for Frozen Shoulder

Elite Spine Model Photo (114 of 89)

Research showed that the outcomes of corticosteroid injections versus a combination of physical therapy and rehabilitation and stretching exercises are similar at 6 months to decrease pain and increase movement.

At Elite Spine Centres, we provide a range of conservative treatment services for pain relief and to restore a proper degree of shoulder motion. The treatment you receive will be personalised and developed according to our holistic approach, the Functional Correction Method (FCM).

  • Manual and instrument-assisted soft tissue therapy: This breaks down damaged scar tissue accumulated over time in the affected area.
  • Cold laser therapy: Excellent at reducing the inflammation build-up of shoulder tissue for pain relief. It also facilitates the capsular release of the shoulder joint.
  • Shockwave therapy: May be used in the later stages of frozen shoulder syndrome. It is a faster and less painful way to break down scar tissue and increase the range of motion in older damaged areas.
  • Manual therapy: Proper alignment of the shoulder and nearby spinal regions ensures proper nervous system control and reduces postural strain on nearby muscles, tendons and ligaments.
  • Physical therapy: Stretching exercises for frozen shoulder are prescribed to patients in conjunction with chiropractic care. This is done to strengthen the weaker regions of the shoulder joint in the affected arm.

The treatment is usually progressive depending on the patients' condition.

At the initial stage, it is crucial to control inflammation, pain and maintain movement with low-grade mobilisation. Therefore, any robust and intensive manipulation on the shoulder joint is contraindicated. Once the pain subsides, the treatment plan emphasises increasing the capsular laxity, movement and muscle strength.

The shoulder is a very complex joint and requires careful, holistic treatment. While you may experience significant improvements from the first session, it is imperative that you carry out your entire treatment plan to prevent the gradual return of the painful stage.

Pain Relief is a Call Away!

If you suspect you may have frozen shoulder syndrome, book a consultation with our well-trained chiropractors today.

We know that seeking chiropractic help for the first time may be overwhelming to many patients. Hence, we prepared a special introductory package covering almost everything you need for your first few visits to our clinic.

Don't wait for your condition to worsen! You can avoid the worst effects of a developing frozen shoulder with Elite Spine Centres.