Frozen shoulder - choices of treatment

Bones, joints and muscles
1

I first noticed the symptoms of FS about 4 months ago - it seemed to come out of the blue for no reason at all. Just as mystifying was what should I do about it - do I go to a physio, GP, acupuncturist, osteopath, chiropractor - or am I better off doing nothing at all?!!

After doing some research, I decided my best course of action would be to go to an osteopath. However, what I would advise other sufferers is to be aware that this can be a very, very long process and can end up costing you a fortune!!

They gave me twice-weekly appointments at the beginning which I didn't mind paying for as I wanted to get myself cured as soon as possible.

The appointments involved gentle manipulation and she would give me exercises to do at home. My arm is gradually getting some small amount of movement back (although my practititioner did say that this was largely due to my hard work at sticking to the exercises) and the pain has diminished (although from what I understand this is part of the disease process and is probably nothing to do with the osteopath!)

In retrospect, I am glad that I sought treatment with an osteopath, but in my naivety I had not realised what a long process it would be and how much it would cost. I am still going to sessions but, at my request, I have staggered the appointments so that they are further apart.

I am now getting pains in the other side and unless I win the lottery, I feel that I couldn't possibly afford to go through it all again!!

2

I suffered for months with a frozen shoulder before going to see my GP, I too tried alternative private treatment but it only eased the pain for a day or so. My GP gave me pain killers which worked really well and set me up with a National Health Physiotherapist, if this failed I was to begin cortisone injections. The Physio was excellent, giving me exercises which I diligently followed, after one month I still could not extend my arm straight above my head,and I was told that I might never get full movement back, so I continued with the exercises and noticed that whilst on holiday and swimming every day full movement was returning. I kept up the swimming, twice a week, on my return home and thankfully after 4 months of physio and swimming I had full movement and no pain. I was really impressed with the NHS service, and unlike private treatments it didn't cost anything.

3

Thank you for your reply. I will certainly consider going to my GP if the other side follows the same pattern as my right side. I know not all GPs offer physiotherapy but it might be worth trying. I will also try and go swimming as often as I can - like you I would rather not go down the route of cortisone injections or surgery.

4

I was really anti-surgery until my FS started affecting my whole life and I had no choice left.

I couldn't get dressed without considerable pain, couldn't wash my hair, wash under my arm pits ... it was hell.

I had MUA (manipulation under anaesthetic) six weeks ago and the improvement has been amazing and now, at last I can function again.

I have to do fairly intensive physiotherapy and hydrotherapy and I go swimming almost every day to loosen it up but without the MUA I am sure that I'd still be unable to move it and still in terrible pain.

It's still uncomfortable and I've had to work hard at the exercises but it was a really good decision. I don't like anaesthetic and would, if it had been possible, have liked to have been able to wait it out, but the pain was so intense, and the inconvenience meant I couldn't work or do everyday things so I chose the operation.

It took ten minutes (literally) for them to 'operate' on my shoulder and I was only in the hospital for four hours.

I am so grateful to the NHS and to the specialist who has helped me. Frozen shoulder made my life hell!!

5

Hi, i have an app for an op in july to have my shoulder sorted. i've been suffreing with it now for months, and been off work since january 2012 ! It is so depressing, as you mentioned, you cannot wash/style yr hair, dress etc, and even my driving is restricted. wash very uncertain about sugery, but am thinking now anything to get my life back on track. Has anyone else found that yr shoulder is more painful in the cold damp weather?

6

Im suffering frozen shoulder from both sides and upper arms already 3 years. Fortunately, when I lied down the pain is gone. Fully agreed that the pain is getting worst during cold weather. Already spent alot of money hoping for the cure as is HELL however I refrain from pain killer. Acupuncture treatment after more than 10 sessions without any slightest result and currently under orthopedic treatment so far 6 sessions and I was told it takes time to see result. Anyone has any recommendation Im a Singaporean.

7

Hi David,

I live in England.

I had my shoulder manipulated under anaesthetic. It was completely frozen and affected my being able to go to work. I could not move my left arm at all and it was so painful too.

The operation has worked, I have had to work hard at physiotherapy and do lots of exercises to keep it moving but it is much, much better and I now have about 80% movement back in it.

I'd recommend this operation if you need to get your arm moving again. I couldn't wait for it to get better by itself because I have to be able to do my job.

It is a very painful condition. I had it for over two years before having the operation. I tried acupuncture which was expensive and did not work, I tried exercises to get it moving again but that had no affect either. I don't like pain killers so I didn't take any of these to ease the pain. In the end my only choice was the operation. I now swim nearly every day to keep it fit and moving and it has really made a different to my quality of life.

It is worse in the cold so I make sure I keep it wrapped up when I go outside.

8

I am suffering from my second frozen shoulder in approximately 5 years. The first time it was my left and lasted around a year. Like most others who have been unlucky enough to have this dreaded condition I spent money on trying every possible treatment because I couldn't get much help from my GP. Nothing worked. Eventually I asked to be referred privately to a rheumatologist who gave me a course of drugs and a cortisone injection followed up by intensive physio. This combination seemed to work - or maybe it was a coincidence and I was coming out the other side anyway! Nevertheless I seemed to recover completely and soon forgot all about what I had been through.

Unfortunately in November 2011 I began to suffer discomfort in my right, dominant shoulder so I tried to get something done about it quickly. By then I had changed my GP but still nobody was interested in my worries about my shoulder going into total frozen mode. Again I paid for physio myself but although this seemed to help with the pain initially it didn't stop my shoulder from completely freezing and this time the excruciating pain on knocking or jarring my arm seemed way worse than I experienced with my left shoulder.

I decided to try once more to get my GP to help and, lo and behold I count myself tremendously lucky. She found me an appointment with an orthapaedic shoulder specialist at a private hospital but it was an NHS appointment. I only had to wait two weeks to go. Two weeks later I underwent MUA treatment in the private hospital but on the NHS. I was dreading it because the idea of having your arm forced into every direction - tearing the scar tissue in the process - was frightening to say the least, even when done under a general. It is only three days since I had the procedure but I was amazed at the results on the first day. The consultant and then the physio come round shortly after you wake up and make you put your arm above your head etc. I couldn't believe that I could do it! I am feeling very positive but all the advice says that this isn't an instant fix. I have to do 10 different exercises five times a day and each one has to be repeated 10 times. I am now incredibly sore even taking the prescribed painkillers every 2 hours, i.e. paracetamol, ibuprofen and codeine. It is a very tough regime but I am determined to win through because I must retain the movement that the manipulation has provided. During the MUA you are given a steroid injection into the joint which helps with the inflammation but I still have background pain although the debilitating pain I was suffering from before has disappeared thankfully. I suppose it isn't surprising that the exercises are very uncomfortable. Not only am I stretching the damaged tissues but I am using muscles and tendons which have not been used to doing much over the past few months.

I hope to report that I am well on the road to recovery within a few weeks but if anyone else has experience of this treatment and can tell me how long it took them to retain reasonably normal, pain-free movement, I would be very interested in hearing from you.

Good luck to everyone out there with this condition, I wouldn't wish it on my worst enemy!

9

I am also suffering from frozen shoulder and two weeks ago underwent capsular release surgery, I can say that so far so good, it's not an instant fix but the 24 hour pain has gone and the pain I'm in at the moment is nothing compared to what I have gone through. My shoulder started to get painful about a year ago but I thought I had pulled a muscle as I'm a photographer but about 7 months ago it started to freeze Nd I could not even touch my face it was so bad, I underwent physio acupuncture and my shoulder was trapped up and nothing he helped. It is the worst thing I have had to endure and would not wish this on my worsed enemy, I have not

Slept properly in months and would just sit and cry many nights not knowing what to do with myself. I went to see my consultant today and he is very pleased with my progress although I think I still have a long journey ahead, unfortunately my other shoulder (right) is going the same way and he performed some tests on me and confirmed this, I'm a bit embaresed to say that I burst into tears the poor guy did not know what to do with. E but was so kind and helpfull and is going to give me a cortisone injection to see if we can nip it in the bud so to speak. I totally sympathise with anyone who is suffering I opted to have the surgery as I was already a year into my sentence and I just. Old not face upto another 2 years waiting for it to unfreeze. Any advise would be greatly appreciated. And good luck to anyone who is suffering and I hope you recover soon.

10

It's now 12 days since my MUA and my shoulder definitely feels looser. I have maintained the amount of movement gained from the procedure but my shoulder is very sore and I still get referred pain down my arm and across my shoulder and up my neck. I think this is aggravated by the physio but have been told that the muscles need to be stretched back to their original length - disuse makes them shrink and buckle; they will also need to be strengthened by exercise. I'm reporting my experiences because I have been so frustrated by the fact that no-one has told me what to expect. I was totally in the dark about the stages in the treatment and how soon I could expect to see an improvement. I kid myself that I don't need the painkillers because it's so much better compared to before and immediately after the MUA. However, not taking them does put me off the exercises because the stretching is quite hard - I need to hold each one for 30 seconds which is like torture.

Anyway, I hope this will help someone else who is going through this. Best of luck to all you fellow sufferers!

11

Hi judyb, gosh it's hard isn't it? Had physio yesterday and can hardly move today, worst it has been since the op, I had capsular realease surgery which is keyhole surgery where they take away all the inflamation, is this the same as yours? like you I did not know what to expect but was told it was a quicker fix but no magic pill. Trying very hard to stay positive, back to taking all the meds regularly today as I'm in discomfort and pain and very stiff. as I said before my other shoulder is going the same way and found myself tangled up in my clothes this morning while trying to get dressed. Couldnt even use my good arm, Also trying to stay very calm and relaxed as I think the more stressed you are the worse it is. Anyway thanks for posting healing vibes sent your way.

12

Hi Summeralex. Yes, really hard but it sounds as though you are worse off than me. This is my second but not sumultaneously, what a nightmare for you, I feel so sorry for you and am not at all surprised that you get depressed!! Someone at the hospital was having both shoulders treated with the MUA whilst I was there. This procedure isn't quite the same as your treatment. With mine they literally pull your shoulder into all it's rotations whilst you are under a general anaesthetic. This means that the adhesions are torn and stretched inside the capsule. Then they put in a cortisone injection to help with the inflammation whilst it heals. Apparently it isn't necessarily successful, it might just refreeze. It's also extremely painful for the first few days (and still is pretty sore). I don't think there is an actual cure and they don't know what causes it either. I thought I'd had a frozen shoulder once years ago when I fell on it ski-ing. I couldn't lift my arm properly for a few weeks but it got better quite quickly. This is completely different isn't it? The problem is that no-one who hasn't suffered from it really knows how bad it can be so explaining how hard it is to cope with day to day work, family and social stuff is hard for most people can comprehend. Anyway, let's hope we are both on the mend and that your other shoulder can be treated early to stop it going the whole way.

PS: I hear that swimming can be really helpful. I wish I had tried that when I knew my shoulder was getting worse and worse but before it eventually froze completely. Everything else was a waste of time and money but the cortisone has always been helpful in my experience.

Good luck Summeralex. Let me know how you get on.

13

Hi Judyb, thanks for reporting, I thought I need to report mine too. As what u had said, no one told us what to expect. I have got my MUA done 5 days ago.My specialist told me before the procedure that MUA is a fast fix, if u don't want to wait for your body to heal itself which could take years and the pain become too hard to bear.

My doctor told me I can get quick fix, but until now I still feel pain, I not too sure if it is normal, but since u also have same experience that pain still remain, it kind of make me feel more relief as I know that I am not alone. As of now, 5 days after the MUA, my only noticable result are, I can lift my arm up from the front and by the side 90 deg, though still has some pain, but compare to before, I only manage about 50 deg and the pain was already unbearable.

For any one who wish to do MUA including David from Singapore (I am SIngaporean as well) let me share my experience until today:

1) After the procedure, your affected arm will be numb and heavy as they will give you a nerve block as well as anaesthetic. It will last for about 1 day before you get your feeling back.

2) Don't expect to get to normal after the procedure, you need to go thru physio therophy, and trust me, you will not like them, as some said, it is torture.

3) I develop blue back under my arm, I am not sure when it happen, but I just discover 2 days ago, though my feeling after the procedure was that the pain actually move under my arm. My doctor just told me it is normal. I kind of suspect long needle injection during the procedure cause that.

4) All I want to say is, I still in pain, not some say that MUA has amazing result, however I am still only in 5 days after the procedure. I hope that if my condition really able to get improvement within a month, I will continue the report here and encourage those who wish to go thru MUA to go ahead.

Good luck to everyone, it is nice to find you guys here, but it is really not nice to have Frozen shoulder, it is in fact hell. Please keep the reports coming.

14

Hi Judyb, thanks for reporting, I thought I need

15

It has been 12 days now after my MUA procedure. My pain still did not improve. I probably think that MUA is not the best fix or faster fix.

16

Hi Steadyang. My experience is very much the same as yours. It is now 4 weeks since I had the MUA and I have a lot of movement back now. I can do pretty much anything although I still can't put my arm behind my back. I still get quite a bit of discomfort, i.e. aching, tingling and sometimes a flash of pain if I go beyond my limits. I have had a lot of physio, one week three times, and it has been very painful. I think one of the worst things now is that I realise how much the muscles of my upper and lower arm, my neck and my underarm had detiorated whilst not being used. They shorten and buckle due to lack of use and need to be lengthened and strengthened again, this is what I'm now trying to achieve but it is a slow process. The physio gives me massage on the trigger points of my muscles to release the knots in my muscles. It's agony at the time and then takes a couple of days before I can even touch the spots involved. It does make me feel better though.

For anyone else out there considering this procedure I would say do it. It isn't an instant - and definitely not an easy fix - but I am convinced that I would still have a frozen shoulder if I hadn't had it done. Bearing in mind what state my muscles were in after 9 months of little use I think I would have been much worse off if I had waited for it to fix itself - not an option as it's my right arm.

Good luck to anyone else out there, I'm hoping I will be normal soon but will continue to post and let you know!

17

PS: I do still have tenderness round the shoulder joint and was worried that I had damage to the rotator cuff. My physio did tests to check that but says it isn't that. She feels that the cortisone injection probably didn't hit the spot, they don't always work. The muscle tightness seems to pull on the joint too which can make it painful but following massage this is very much diminished so I'm hopeful that this tenderness will go away eventually.

18

Judyb, Yes, I agree that while we are in pain, we restrict our usage, and in some medical report do mention FS will also cause muscle wasting. I can feel that I no longer able to carry object for long, say a 1500cc of water bottle.

I only have 2 sessions of PT after the procedure, most of the time I do it at home by myself.

This is something that I keep asking, should we push ourselve on PT or should we rest our FS, there are mix suggestions in this Forum,even my doctor ask me to do but not to the extend that the pain is unbearable.

I stretched myself on those exercises that suggest by the physio, but at times it was too painful which I am worry it do more harm than good, so I am wondering what is the best way, to work it out even at pain or go general?

Anyway I will continue to post on my progress, I will be returning to work next week.

19

Steadyang

My physio said that I must stretch myself straight after the op even though it was painful but afterwards I must apply ice. Also I had to keep up the painkillers day and night for 2 or 3 weeks until the pain got more manageable. Now that I have quite good movement I am doing more gentle muscle stretching and this also helps maintain the movement in the joint. I don't take many painkillers now - mainly anti inflammatory gel. I even played golf today and it wasn't too bad!

20

So, am I right in thinking that the MUA procedure is worth it. The pain does not change right away (or gets worse) mostly because of the physical therapy required but does get better after a month. Range of motion and use of the arm is immediately better but still extremely painful??

My experience has been one of 5 months of agony. I have a constant ache under the collar bone that radiates up my neck to feel like an ear ache and toothache. It hurts right through - front and back. At times it feels like a heart attack or that something is squeezing my lung. Another pain runs from there through the rotator cuff and down my bicep. I have intermitent pains (stabs and spasms) in the shoulder, bicep and forearm. Right now it is my left shoulder but the right has started too. I have done chiro, tens machine, ultra sound, laser, physio, and accupunture. None of these treatments helped - most made it worse. I am scheduled for cortisone shots in October. Like another post I sleep about an hour - hour and a half and then cry in pain for the next two hours to repeat again. When I jar it or accidently use it - it feels like I have ripped the shoulder off, I can't breathe, I feel like throwing up, it drops me to my knees. Heat helps sometimes. I see a massage therapist 2x a week. He presses on the trigger points (which leave me bruised) that causes a burn and pain of its own. I'm told that it is the muscles receiving blood flow again and the adhesions coming apart.