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Frozen shoulder - choices of treatment

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!!

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  • judyb

    Hi Heather. Poor you, I know what it feels like and I sympathise completely. I have also suffered a lot of pain in my neck and collar bone area and I hate to say that this is something which has also carried on after the MUA to some extent. I think that's because we have been using those muscles to lift the arm because the shoulder joint isn't doing the work. I had the same thing with my previous frozen shoulder too. This is slowly improving a bit but I still get bad days with my neck. I try to stretch it by tipping my head to one side to loosen the tension and I find that a microwaved wheat bag laid around my neck helps to relax it.

    Comparing what you are feeling at the moment with the discomfort following an MUA I do still think it's worth having. It is now 5.5 weeks after my procedure and I am still not pain free, some days are worse than others for some reason. It's a different kind of pain though - certainly nowhere near as bad as the pain you feel when you jar your arm at the moment; like you, that made me feel sick for a minute or more.

    I am still having the trigger point massage. I think my physio has been all over my shoulder, neck, upper and lower am and week by week there isn't an inch of muscle which hasn't felt like it's been hit with a hammer. I do think that when my muscles have finally lost the tension and waste products which have built up over the last months, and regained some proper strength, I will begin to feel much better. For me, it isn't a question of just having regained 75% of my movement back, it's more about feeling more comfortable and having my quality of life - and sleep - back again. I am beginning to feel that it isn't far off.

    I go back to see the surgeon on 14th August and I'm hoping he will think that my recovery is normal. My physio says she isn't familiar enough with this procedure to know whether I should have full movement back by now. I definitely haven't got that yet but enough to do most things I need to do.

    Good luck with getting your shoulder treated. I hope and pray that your other shoulder isn't going the same way.

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  • Steadyang

    Hi Heather, yes I sympathise your experience and whoever in this forum discussion suppose to suffer what you are suffering, hope this make you feel better.

    Sorry that I did not quite get you about MUA, whether you are seeking advice from people here that if MUA is worth doing which you have not decide to choose this treatment OR you actually go thru MUA but questioning its effectiveness.

    Nevertheless, It is time for me to report my progress 3 weeks after my MUA procedure.

    1) Range of motion, I definitely gain more than what before. Now I can acheive, elevating arm from front up to 180 deg over my head, and the side too. Before the MUA I only mange the most 120 deg, and my bicep feel the pain that I just cannot move further. Currently I can do it quite effortless, however if I stretch further I felt my shoulder joint is aching. I can even reach behind my back , which according to my specialist will normally be the last that can achieve, though there is still some pain, again on my shoulder joint, but managable.

    2) About Pain, in term of this, I must say, do not expect it to go away quickly after the MUA, now is my 3rd week, pain still there, as what judyb state, sometime good sometime bad, and different kind of pain, I don't know how to explain. But yes, still PAIN, but it for sure not the same like before, such as trying to reach above my head, it is unthinkable before that, I now can do it with some uncomfortable. I am not going to say thing like "the pain is totally gone!", No, miracle did not happen, at least to me. I am some one that do not like taking pain killer, I stop taking after 1 and half week after the procedure. I am managering the pain.

    Next, I realise that now, unconsciously, tendancy that my affected arm now do not straighten fully when try to reach out to get something, it tend to bend on the arm, some call it "chicken wing" effect after frozen shoulder. I will try to correct it.

    I must said that I really do wholeheartedly on the phyiso execerise that being advice, at least twice a day, one before breakfast, one before dinner. Some time at work, if there is time, I also do a bit of stretching.

    I do not believe in this execerise at first, before MUA, hand climbing wall, stretch hand in front your chest, use belt to stretch your hand behind you back, etc, because basically I cannot do it due to pain. However, after MUA, I think I began to feel this execerises really do good, and most important I really can manage doing it with managable pain.

    I do hope that I will be getting better and better, but right now, it is not close to normal, and I believe I need to get my strenght or muscle back on my affected hand as well.

    Stay tune for my future report, if anyone can still wait, see how is my progress before decide to take the MUA.

    There is still judyb who is also reporting his progress after the procedure, which he did about 2.5 week earlier than me.

    Judyb, I am excited to hear you are playing golf already, good for you. I enjoy basketball and bowling, but I think it is still beyond me right now.

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  • judyb

    Hi steadyang. I'm glad you are making progress. It sounds very much as though you have experienced the same stages I have.

    I too have suffered the chicken wing effect. My physio has worked on my lower arm to try to lengthen the muscles which have shortened due to lack of use. It is a lot better now but I still find myself keeping my arm bent when in bed at night because having it straight feels weird, though not exactly painful. My physio has recommended that I have my arm straight out in front of me and supported on a surface but with my hand hung over the edge. I have to hold a heavy book or a large tin of soup or something in my hand. This is meant to stretch and strengthen my arm further. I also have a band which i stretch in all directions to strengthen the muscles.

    Unlike you I cannot put my arm behind my back yet but to be honest I can wait for that to come back. I can already do more of my pilates exercises and, as mentioned, I can play golf so that is increasing my strength and fitness too.

    Good luck to you - and to Heather - I will keep reporting if it helps others.

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  • conniev

    Hi everyone-

    Here is my story. I had an mua and capsule release 6 weeks ago and I have to say that I am getting very scared at this point. For the first few weeks after the procedures, I felt that I was improving but now it seems that all the pain that I experienced before is back with a vengeance. I have been going for physical therapy and doing my exercises as prescribed but it seems like the pain is never ending now. I am still taking my pain medication which scares me because I do not want to become addicted but nothing else seems to help. I have another follow-up with the surgeon on Thursday and my physical therapist has suggested I ask him about cortisone shots but I am wondering if anyone here has gone that route after this surgery. Any suggestions would be much appreciated.

    Thanks.

    Connie

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  • HeatherL

    Hi All.. I had a cortesone shot 2 weeks ago.. and since have had relief. The shot itself was not at all painful (freezing 2 ml and cortesone4 ml together) It was uncomfortable the next day and evening.I can let the arm down (from the chicken wing) and even let it swing a bit when I walk. I see an Xray tech in 9 days. He will use xray to inject air into the joint to separate the adhesions. Reports say this is a 15 minute procedure that you get full pain release and 85% movement back- we'll see. I saw an top orthopedic surgeon who said that "there is no medical evidence that anything works for frozen sholder" My right shoulder has progressed to the pain when used stage.. not the extreme pain yet.. but pain that stops you to breathe for a couple of minutes.

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  • Gerry the neck

    Hi

    "I saw an top orthopedic surgeon who said that "there is no medical evidence that anything works for frozen sholder"

    Sorry to say he/she is right. Usually, with frozen shoulder, there is absolutely nothing wrong with the shoulder itself. Mostly it results from a trapped or threatened trapped nerve in the cervical spine (the neck). Some aggravation to the neck causes the shoulder muscles to go into cyclical spasm. Normally it self resolves after about 10 months with no residual damage. The first 3 or 4 months are usually very painful, requiring painkillers, but after that the pain decreases until it finally disappears after 10 months or so. I've had FS 3 times in the last 20 years, and each time this is exactly what happened, with no treatments ( except nurofen before bedtime ) or exercises whatsoever, except sometimes I had to sleep on a sofa or armchair because It got worse when I lay down horizontal. It does eventually go away if left alone. Sometimes, i read these posts and I worry that people are having all sorts of interventions to the shoulder itself, and maybe are unknowingly exacerbating the problem and extending the recovery time. Any professional worth their salt would confirm that FS self resolves with no interference. Unfortunately, some think that they must be interfering aggressively , perhaps because they don't want to look unprofessional by doing nothing.

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  • HeatherL

    Thanks Gerry, I get it... but honestly, my pain on the left shoulder has been intense since June. Only relief was the cortesone shot 2 weeks ago and sadly it seems to be wearing off. I will try anything to end this, especially as my right shoulder is reaching that intense pain period. I'm sure that is what motivates everyone here to continue paying through the nose for physio, chiro, acupuncture, massage... anything that seems to work... even for a short period.

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  • Gerry the neck

    Ok. we must do what we must do. I have heard that cortisone injections can help in some circumstances. But, its more the exercises or surgery that concern me. The arm should never be exercised above shoulder height, nor should it be forced to the rear. By staying within the limitations allowed by the shoulder, it will heal sooner. I don't know if you are aware of it, but sometimes just altering sleeping arrangements can be beneficial. Try sleeping or napping on a sofa with a good pillow and see if it makes a difference. Sometimes just following the same routine each night, i.e sleeping in a bed, encourages the cyclical repetitiveness of the symptoms. A change can do good. I know how painful it can be, especially in earl;y stages, but the clinics don't always have the solution. There are things you can do yourself. Check on internet for home management of FS.

    Gerry

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  • judyb

    Gerry I agree that it's probably neck problems which are at the root of frozen shoulder because I have osteo arthritis in my neck and have had FS twice. The first time I had a cortisone injection which helped immediately and my physiotherapist included neck exercises in my recovery regime, I was better within 3 months of getting help. I do think, however, that not all frozen shoulders are the same. In spite of trying to look after my neck I still got the second FS and it was very much worse than the first and on the opposite side. I was a bit reluctant to undergo the MUA because it is a very aggressive treatment but all in all I'm glad I did. I had a cortisone injection following the procedure but it didn't seem to help on that occasion. However, I'm sure I would not have recovered by now without the op, and being pain free and having 90% movement back after 4 months is a huge relief. I'm usually one for letting nature take its course but this grim condition drives most of us to seek help of any kind.

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  • Gerry the neck

    Hi Judyb

    I know. I remember how desperate I got for any treatment. First time I had FS I had Osteo, Acupuncture, Exercises advised by Physios plus painkillers etc.. The second and third times I had it I just left it alone, made sure I didn't aggravate it, and it seemed to ease off sooner. And, I am aware that, without trusting that the easing will happen anyway, its difficult for anyone to cope with the daily struggle during the early first few months. Of course, everyone is entitled to seek whatever remedies they think might help, but its as well to know when making those choices what the long term forecast for the problem is. I think, if you check on the net, that most qualified descriptions of FS will support the self resolving aspects. The condition creates its own sense of impatience and frustration, but that's probably not the best mindset to be making decisions in, paticularly where those decisions might have long term consequences of their own. I'd advise patience first, i.e. try and bear the first 3/4 months, and then if nothing improves it might be time to consider other means.

    Gerry

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  • Gerry the neck

    ps......one of the problems with FS is that its impossible to guage whether treatments have worked in any beneficial way when the condition is inclined to self resolve anyway. However, if the condition extends beyond it's expected time span, then its probably right to blame the applied treatments for encouraging this.

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  • jillgrace

    I am inclined to agree with you Gerry. My first frozen shoulder was on the right side, my dominant side, and I've never felt pain like it, it was absolutely unbearable. My osteopath told me I had a bit of arthritis in my neck but didn't seem that concerned - they said that almost all people get some arthritis in their necks once they reach middle age and just dismissed it.

    But when I then got it in the left side, I couldn't help wondering that my neck might be to blame - I couldn't think what else could possibly cause both sides to freeze up. I've spent my whole life doing office work, and I feel that my constant 'bent over a desk' posture may well be to blame.

    My left side froze up in the identical manner to the right side, but the strange thing is, I've hardly had any pain on the left side .I really don't know why this is.

    It could be that I exercised the right side quite vigorously and sought treatment by an osteopath but for the left side I didn't seek treatment and have done very little exercise in comparison. I am still 'frozen' on the left side but it is getting considerably better to what it was, with very little effort or expense!

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  • psychochief

    hiya folks cheesygrin

    what an interesting thread, i 'got' a frozen shoulder a few months ago and the pain was a weird pain i had never experienced before, very nasty indeed, i was duly given pain killers and anti inflammatorys and refered to a physio by my doc, (i declined her kind offer of an injection into the joint lol O_O)

    however on researching FS the physical interventions just did not 'sound right' to me rolleyes so i didnt book a physio appointment, i told my doc i would do some exercises at home, jeeeeez what a nightmare, i thought i was pretty much ambidextrous, not so, it was absolute agony wiping my own bum and not being able to do the simplest of tasks, even sleeping, its amazing how many times you bump into things without realising it normally, you soon notice with FS thats for sure 8)

    im with gerry on this one, ive just used my arm as much as i can without over doing it, using it untill i feel pain but not excruciating pain and hey presto its getting a lot better, i still cant put my arm behind my back etc but its slowly getting there im pleased to say, i really dont think aggressive physical intervention is a good idea at all, it strikes me a physios mantra is 'no pain, no gain', also its the luck of the draw whether you get one that truly knows what theyre doing, i say leave well alone unless its the last resort cool

    cheers,

    Ken~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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  • HeatherL

    Ok.. question.. Those of you that left it alone... how frozen did you get. (Where did it lock up)? My left shoulder will only rise about 11 inches from my side. Right now, I can still lift my right arm to my ear.

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  • Summeralex

    My story, about a year ago I started feeling pain in my left shoulder nothing too bad just a kind of "oh I think I have pulled a muscle" kind of thing by Christmas my shoulder started freezing, but like most of you I was just "getting on with it" self medicating at home. I'm a schools photographer and was in my most busiest period and working was agony, unfortunately for me (and my son) my son ruptured his cruciate ligament and was undergoing reconstruction surgery the news was devastating for us all (he belongs to a professional football club) and was very stressful (I think stress plays a major part in FS) as like many of you I have also suffered with neck problems and I just seem to seize up when I'm stressed. Anyway, by Easter I could not sleep, wash myself, eat with my left hand as I now could not even touch my face with my left hand I thought enough was enough and went to the doctor, I have private medical so was referred to a consultant and PT very quickly, intense PT and acupuncture and strapping of the shoulder did not help at all, and by this time my right shoulder was starting to show signs of FS, I had to go back to work after being off for the Easter period and at first my shoulder did improve for a week or so and then the pain was so unbearable I was now serviving on about 3 hours sleep a night and was so out of it on medication I was hardly functioning but being a working mother of 2 teenage kids (luckily for me they and hubby helped a lot) I soldered on wink. I was booked in for a capsular release in June, (I get 12 weeks summer holiday, lucky me) anyway, after the surgery I can honestly say I hardly had any pain, I only took my mess for about 5 days, I did have to work hard at getting my movement back and now even though its not 100% my life has returned back to normal, my right shoulder is not right I have had an injection and it did seem to help I may have to have another one it did not hurt at all. So I think everyone is different everyone's circumstances are different I would not of been able to carry on with my job if I did not have the surgery (in my opinion) and I know surgery is not magic quick fix but I just could not wait the months for my shoulder to unfreeze. So all in all life is starting to look brighter, oh and my son is going back to football in January and has been given another years contract. So all good. That's my story smile

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  • judyb

    Hi everyone

    It's really interesting to hear a range of experiences because those of us who have had more than one FS seem to have had more pain on one side than the other. If it's true that the dominant side is more painful - certainly the case in my own experience - then perhaps the extra aggravation of HAVING to move it so much more is the cause. This would back the theory that doing nothing, and certainly not physio, may help to speed up the recovery time. Easier said than done though and I hope I never have to test out this theory in the future! Good luck to you all and I hope that any new sufferers exploring this website may benefit from our stories, I know it has helped me to know I'm not alone; sympathising with each other has been a good source of support. confused

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  • HeatherL

    What I have noticed.. is that anyone that preservered for a period of time before seeking treatment seems to find the treatment useful. In other words they could have been at the point of changing stages... from freezing to frozen or frozen to thawing. I am right handed.. my left shoulder is frozen and my right is working on it. So far the pain has not been as bad on the right. I think partly because the other was sooooooo bad that I have a higher tolerance now. I'm not pushing the right at all, in hopes of stopping the process... I know wishful thinking. I would try anything to stop it... I dread losing my ability to wipe my own butt, wash my hair, etc. Any experience on this??

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  • Gerry the neck

    Hi

    Firstly, in response to Heatherl, I don't think there's anything to worry about in terms of the FS symptoms becoming permanent. Most ex sufferers will agree that it returns to normal eventually, perhaps with a different time span for each individual. This all points to the fact that there is usually nothing intrinsically wrong with the shoulder. I'm a decorator, and whenever I had it (3 times, each lasting 10 - 12 months) I found that When I was standing I could still work as long as I didn't raise the offending arm above shoulder height, or try to reach around behind me. Both of these movements seemed to be the main aggravators. I also had trouble washing, shaving etc but only in the first few months. However, when I sat down, or lay down, the pain just intensified. So I had to find sleeping positions where this effect wasn't so bad, and I think once I'd experimented a bit and got the hang of it, it started to improve. My sofa proved invaluable. I now believe that its the position of the neck when we sleep which determines the severity of the symptoms. It may well be slightly different for everyone, depending on their different vulnerabilities and tolerances, but I suspect the source and the key to treatment is the same. I think I could go to 5 different professionals for advice and find that they advise 5 different treatments !

    It was nice to read that other posters had similar experiences, and I'd hope that that should help with reassuring those who are new to it.

    Gerry

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  • Steadyang

    I do not think I got thru so call Pain-Freeze stage, of course I am not sure there is any Thawing stage, because I gone thru a MUA, which it did help by getting my range of motion back within week. However the pain still there, at the shoulder joint, and sleep still a problem.

    I just like to find out when some one say he/her shoulder get frozen up, is it mean it is the pain that prevent he/she to move further? Or the shoulder just frozen up without pain but cannot move to the range once it can, such as we cannot rotate our head all the way to the back, but when we try, it just stop to the limit but without any pain.

    In my case of frozen shoulder, it is the pain that prevent me from going further, such as only able to elevate from hand rest at the side position up to about 120 deg to the front with arm straighten, normaly we should able to go up to as far as 180deg. It is the pain that prevent me from execute the movement, it was not just frozen. So I do not know what is the common saying that there is a Pain-Frozen-Thawing stages. I felt the Pain & Frozen are togehter all the time.

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  • Gerry the neck

    Hi

    The term Frozen is used in the metaphorical sense that normal movement is restricted within certain limits, otherwise it causes pain. The limit differs for everyone, at different stages, but a good common denominator would be raising the arm to just about shoulder height before the pain kicks in. Its still possible to raise above this height, its just too painfull. And, of course, the pain can also intensify in certain sitting and lying down positions with no raising of arm whatsoever ( yet another reason for suspecting that its not the shoulder itself which is causing the pain). So, the shoulder isn't 'frozen' as such.....its simply restricted. There is no 'thawing out'.....but there is an easing of the restriction (hopefully) , usually over a set period of time until the problem resolves itself (again hopefully). It does seem that some people get more restriction...i.e only ably to raise arm a matter of inches, and with some people it takes longer to resolve, but these are usually the exeptions to the rule ( I know, not very helpful if its you ). With regard to movements and exercising, i think its obvious what the shoulder is trying to tell us.......don't extend your arm beyond the points where pain kicks in. If a need is felt to have to exercise it, always stay within the pain-free limits allowed, and it will most likely heal sooner. Why the Physios always seem to insist on testing yourself against the pain is just beyond my comprehension. You wouldn't normally see a need to have to exercise your shoulder, so why should it become necessary when your shoulder is even more vulnerable. Crazy !

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