Frozen Shoulder
This is a condition whose cause is unknown ( idiopathic ) that is unique to the shoulder. It causes severe pain in the shoulder in the initial stages that is severe enough to prevent sleep. Almost immediately the shoulder starts to become very stiff and a key point in the diagnosis is restriction of external rotation. The x-ray of the shoulder is normal. If untreated the condition will gradually get better going through three phases called freezing (±6 months), frozen (±6 months), and thawing (6-12 months). Physiotherapy has not been shown to be beneficial. The 'gold standard' has been a manipulation of the shoulder under anaesthetic. However steroid injections into the shoulder joint with distension have as good an effect as manipulation without the need for general anaesthesia and the risks of such a manipulation. In the last resort arthroscopic release of the shoulder can be undertaken but this is usually only required in diabetics where frozen shoulder is a much more difficult problem to treat reliably.
