Introduction
Frozen shoulder is a chronic long-term condition which causes significant shoulder pain and stiffness. Frozen shoulder reduces the ability to work, rest and play. Even the small activities of daily living (such as washing and dressing) can be severely affected by a frozen shoulder. Frozen shoulder affects, on average, 5% of the population.
Although we currently do not fully understand what causes frozen shoulder we do know that it is most prevalent in women, diabetics, people aged between 40 and 70 and after an accident. Unfortunately, a frozen shoulder can take many years to settle down with many residual symptoms remaining unresolved.
Frozen shoulder does not only have negative physical connotations but affects mental health too. This blog reviews new evidence, uncovering how frozen shoulder is perceived and why injection therapy has become the treatment of choice for patients suffering from this debilitating condition.
When the pain and stiffness associated with a frozen shoulder is felt, patients will usually make an appointment with their G.P, which often leads to a prescription for painkillers and a referral for physiotherapy; these treatment measures often have little to no effect.
Research has shown that going via the NHS system to gain a diagnosis and accessing fast effective treatment, can often be a lengthy process, which causes significant anxiety and frustration for patients.
A delay in both diagnosis and treatment, can result in emotional and psychological distress (King and Hebron., 2022). This, coupled with pain, a lack of sleep and a reduced ability to undertake simple tasks, results in patients struggling to regain a sense of normality. Pain, frustration and the lack of understanding results in frozen shoulder patients becoming desperate for fast, effective treatment.
Understanding Frozen Shoulder
‘Knowledge Is Power’
The journey to recovery starts by understanding your pain. Without a full, accurate and timely diagnosis successfully treating any condition can be like taking a shot into the dark. Any delay in obtaining a diagnosis, and starting the right treatment program, can have negative physiological and psychological effects.
Research by Bilsborough et al., (2023) revealed that in the attempt to understand their pain, patients with frozen shoulder believed that the onset of their symptoms was an inevitable result of a normal ageing process. Patients believed that they would have to live with their pain for the rest of their lives and so their perception of their own body image changed accordingly. This research revealed that when looking in the mirror patients see an older person looking back.
The negative perception of body awareness and ageing associated with frozen shoulder is unnecessary and could have easily been positively influenced by gaining a fast and accurate diagnosis. Understanding that a frozen shoulder is not part of the normal ageing process, and that there are effective treatment options available is an essential aspect of the recovery process both physically and mentally.
How do I get a diagnosis of frozen shoulder?
As previously described, a frozen shoulder is characterised by increasing shoulder pain and stiffness. Tasks such as raising your arm above your head or behind your back can become increasingly difficult.
Diagnosing a frozen shoulder can be quickly and easily made using a combination of clinical tests and a diagnostic ultrasound scan.
A series of clinical tests are used to assess the strength and flexibility of the shoulder after which a diagnostic ultrasound scan can be used to rule out other conditions, which could be masquerading as a frozen shoulder. These include rotator cuff tendinitis, rotator cuff tendon tears or shoulder bursitis.
At Complete physio our team of clinical experts understand the stresses having a frozen shoulder puts on people. Our team are all highly experienced physiotherapists, musculoskeletal sonographers (ultrasound) and injection therapists. This gives us the unique ability to make fast and accurate diagnoses as well as being able to provide the best, evidence based treatments available.
If you think you might be suffering from a frozen shoulder call or email Complete 020 7482 3875 or email injections@complete-physio.co.uk.
What are perceived impacts of a frozen shoulder?
Personal Impacts
Suffering from a frozen shoulder has been shown to cause a negative effect on both work and social life. Patients have been reported to describe frozen shoulder as a ‘hidden disability. Due to the lack of a ‘visible disability’ frozen shoulder sufferers report frustration with work colleagues, friends and family members for not understanding their condition. The ‘hidden’ nature of a frozen shoulder has been shown to cause additional stress on sufferers in social environments or situations, causing many to become less outgoing and more introverted (Bilsborough et al., 2023).
The Impact On Others
Frozen shoulder was reported to have additional effects on the people close to the sufferer. Work colleges may have to take on additional job roles and family members or friends are often relied upon to provide additional care duties. Losing one’s independence and an increased reliance on others can result in feeling guilty. A vicious circle feeding into the negative loop of pain and disability associated with frozen shoulder.
The negative impacts having a frozen shoulder can have on you and others can be quickly and effectively reduced by getting the right diagnosis and treatment. Our team of clinical experts are here to help. We understand the pressure to return to ‘normal’ as soon as possible.
To discuss how we can help call Complete 020 7482 3875 or email injections@complete-physio.co.uk.
What do patients think about corticosteroid injections for treating frozen shoulder?
New research undertaken by Bilsborough et al., (2023) concluded that because of the physiological and psychological characteristics associated with this condition sufferers of frozen shoulder desperately seek out an injection believing this to be an essential part of their recovery.
Having an injection can be a daunting thought. Although many patients are apprehensive about having an injection (either due to the perception that it will be a painful procedure or because of the apprehension of being given a steroid), it remains widely believed that an injection is the most effective treatment option available. There is a wealth of research suggesting injection therapy to be the most effective treatment option available for frozen shoulder. Because of this, injection therapy is actively requested by the vast majority of frozen shoulder sufferers.
Research has shown corticosteroid injection to be a fast and effective treatment option for the pain associated with frozen shoulder. Furthermore, an ultrasound guided injection has been shown to be a highly accurate, effective option which causes less post injection complications than a non-guided injection. During an ultrasound guided injection an ultrasound machine is used to guide a needle directly into the shoulder joint where a dose of corticosteroid (and local anaesthetic) is deposited.
To ensure you get the best outcomes possible all injections at Complete physio are undertaken by clinical specialists, using ultrasound guidance. All our clinicians are highly experienced in performing injections for frozen shoulder. If you would like to discuss your frozen shoulder with one of our clinical specialists or would like to book and appointment on Complete 020 7482 3875 or email injections@complete-physio.co.uk.
An injection should be seen as the start of the road to recovery. A corticosteroid injection is designed to reduce your pain, allowing you to undertake a progressive physiotherapy rehabilitation program. Stretching your shoulder after an injection is essential to maximise your outcomes and should be started within days following an injection. After an ultrasound guided injection at Complete your clinician will be able to guide you through your post injection recovery and will provide you with a set of appropriate exercises.
Don’t put up with the pain and restrictions associated with a frozen shoulder call Complete Complete 020 7482 3875 or email injections@complete-physio.co.uk and start on your road to recovery.