Frozen Shoulder Flashcards
Frozen shoulder AKA
Adhesive capsulitis
Characteristic features of frozen shoulder
Global restriction of shoulder movement on both active and passive
Frozen shoulder is more common in patients with… (comorbidities)
Diabetes
Thyroid dysfunction
High cholesterol
HTN
Is frozen shoulder more common in men or women?
Women
What age group is frozen shoulder typically seen in?
40-60yo
What investigations are recommended in suspected frozen shoulder?
Clinical diagnosis. Investigations are generally not required (xray & USS will be normal)
Symptoms of frozen shoulder / pain features
Pain can be severe esp at night
Can radiate down arm
Sharp severe pain on certain movements
Substantial functional limitation
Key differentiating feature is stiffness
Phases of frozen shoulder
Painful phase lasting 2 – 3 months
Stiffness lasting a further 3 – 12 months
Then a gradual return of function over the next 6 – 12 months
Intra-articular corticosteroid is most likely to be effective in which phase
Initial painful phase
During the painful phase is the shoulder painful at rest or on movement?
Shoulder is painful at rest and on movement
Is surgical management generally required?
Conservative management = mainstay. Surgery reserved for most refractory.
Is the shoulder still painful during the stiff phase?
Pain when moving beyond restricted range but comfortable within the available range and no pain at rest
The shoulder may still be painful to lie on, but the constant aching night pain has subsided.
Conservative management involves…
Education - expected course with improvement over time, may take 18m to resolve
Regular and breakthrough analgesia
Physiotherapy
Intra-articular corticosteroid injection
When should physio be done with frozen shoulder?
Once acute painful phase settled (will tend to exacerbate in early stage)
When to request ortho review for possible surgical intervention?
If intolerable pain despite steroid injections or if diabetes
