Frozen Shoulder – Is Osteopathy An Effective Treatment For Rapid Recovery?
A frozen shoulder is generally very uncomfortable and makes life very awkward with the stiffness in the shoulder. The correct name is adhesive capsulitis of the shoulder. The onset is normally gradual and there are a variety of possible causes. Prior problems with the neck or elbow are common as is a fall perhaps forgotten in the previous few weeks or months.
The nature of a frozen shoulder is that it progressively worsens and it is this very gradual deterioration that prevents many from realising there is a problem until at least 3 months has passed. Often the affected arm will become painful making it difficult to sleep on that side at night time. There will also be pain in the surrounding muscle bulk commonly. The condition affects women more so than men and most frequently aged 40’s, 50’s and 60’s.
Unfortunately, the progressive nature of the condition means that it is often not seen in clinic until it is very advanced, by which time there is severe immobility of the shoulder.
On the upside, it is rare for there to be more serious complications. Treatment osteopathically is normally sufficient for the condition to improve substantially if a treatment program is completed. For competitive sports players, a structured rehabilitation programme is essential to restore mobility as well as for continued improvements in the shoulder.
Of all the major joints in the human body, the shoulder joint has the greatest range of movement. This is facilitated by a very shallow ball and socket which is held in place by the rotator cuff muscles – a group of 4 muscles and tendons surrounding the shoulder joint, that also control the complex motion of the joint. The process leading to a frozen shoulder is not fully understood, although it is likely that damage or impingement of the rotator cuff causes inflammation and stiffness. Because the joint is likely to then be protected, the stiffness worsens gradually leading to a frozen shoulder.
Unlike the back or the knee which are weight bearing, the shoulder joints are such that you can protect them by reducing their usage. It is likely that this becomes part of a compensation pattern subconsciously meaning that the joint becomes further immobilised and the stiffness develops still further.
Once a frozen shoulder is suspected, osteopathic treatment should be started as soon as possible, if the recovery time is to be shortened as much as possible. Medical opinion is that frozen shoulders typically take 18 – 24 months to recover if untreated. The majority that present to me in clinic are not frozen solid as they are seen earlier enough to prevent that. These are then treated and recover normally within 2 to 3 months.
It should be remembered that frozen shoulders are often caused by or result in problems in other areas such as the neck, back or elbow. It is therefore highly important that the cause and underlying factors are properly investigated. Your osteopath will help here looking into any underlying factors as well as posture and lifestyle. This is vital to ensure a rapid recovery as well as ensuring that the injury is not allowed to recur.
Your osteopath will use a variety of techniques in your treatment. These range from the very gentle to the rather more forceful depending upon your situation and your preference. They are likely to include treatment to the shoulder as well as to the neck and back coupled with posture and lifestyle advice. Treatment will continue over a period of weeks or months.
Keep using your shoulder joint as normally as possible. Seek advice sooner rather than later. Take professional advice and make sure you follow it – there is no quick fix to treating frozen shoulder, it is a gradual process. Make sure that you carry out any prescribed exercises regularly. Avoid making the shoulder too painful as this will increase the inflammation and stiffness, slowing down the healing process.
What Do You Do If Osteopathy Does Not Work?
There are a small minority of cases where manual therapies are insufficient and surgical options need to be considered. In this situation a shoulder arthroscopy may be suggested to investigate, repair or free up the frozen shoulder. Rarely, where there is extensive damage to the joint, a replacement joint may be considered. However, it should be remembered that this is a complex joint and surgical replacement is more difficult and less common than hip or knee replacement.
The purpose of this article is to educate. While every effort has been made to ensure its accuracy, its content should not be construed as definitive medical advice or health advice. It is not a substitute for professional examination and advice. Because each individual’s health care needs are unique and because medical knowledge is always evolving, please consult a qualified health care professional to obtain the most current recommendations appropriate to your needs. Neither the author nor the publisher shall be liable for any outcome or damages resulting from reliance upon the content of this publication.
About The Author
Robin Adams is a UK Registered Osteopath and owner of Littleham Osteopathic Clinic in Exmouth, Devon. He is webmaster of http://www.theosteopaths.co.uk/