To mark Stress Awareness Month, we’re looking at a common condition – frozen shoulder – and asking whether it can be caused by stress.
What is frozen shoulder?
Frozen shoulder – also called adhesive capsulitis – is pain and stiffness in the shoulder that normally begins gradually and worsens over time. There are three distinct stages to the condition and each stage can last several months:
- The freezing stage is when your shoulder starts to stiffen and lose range of movement When you try to move it, you experience pain which can be intense.
- The frozen stage is when pain may start to lessen but the stiffness worsens and it may be increasingly difficult to use your shoulder.
- The thawing stage is when the movement in your shoulder slowly starts to improve.
Common causes of frozen shoulder
A frozen shoulder occurs when the connective tissue surrounding the ligaments, tendons and bones of your shoulder joint (called the capsule) starts to thicken and tighten. The reasons for this aren’t completely understood but doctors believe that the following play a part:
- Age – you are more likely to develop a frozen shoulder if you are over 40. Women are more at risk than men.
- Reduced mobility – if you injure your shoulder (for example, you have a torn rotator cuff or broken arm) or if you have a prolonged period of immobility (due to recovery from surgery or stroke) you are more likely to develop the condition.
- Systemic diseases – certain diseases such as diabetes, Parkinson’s disease and cardiovascular disease makes you more likely to develop a frozen shoulder.
Does stress play a part in frozen shoulder?
Because experts are unclear as to the precise causes of frozen shoulder, it is impossible to say definitively that stress does or doesn’t have a role. Certainly, inflammation plays a part and a person who is susceptible to inflammation may go on to develop the condition. Prolonged levels of stress or anxiety can lead to inflammation in the body and when we are tense, this can gather in our shoulders, causing tightness and discomfort. So, while we can’t say stress is a cause of frozen shoulder, it may be one of a number of contributory factors.
And if you have a frozen shoulder, your symptoms may well be more severe if you suffer from a mental health condition like depression or anxiety. An article published in the International Journal of Preventative Medicine published in 2019 evaluated 120 patients with frozen shoulder symptoms. Researchers looked at the link between depression and anxiety and the range of motion in their shoulder joint. It found that 77% of the patients it studied showed signs of depression. Twenty seven percent experienced anxiety and the same number showed symptoms of both depression and anxiety. Patients were asked to fill out questionnaires relating to the range of movement in their shoulder and limbs. This showed that patients who suffer from depression or anxiety experienced greater pain and disability in their limbs.
Treatments for frozen shoulder
A frozen shoulder can be painful and debilitating but there is an effective treatment that can help. Hydrodilatation is an injection directly into the shoulder joint. It contains steroids and local anaesthetic to relieve pain and reduce inflammation and a saline solution to stretch the scarred joint capsule from the inside, helping to break down scar tissue and improve the range of movement.
It is performed with the aid of an X-ray to identify the right position for the injection. Initially you will be given an injection of local anaesthetic to numb the area. By injecting dye into the joint, the radiographer can see on the X-ray that the needle is in the correct part of the joint. Next the mix of steroid, anaesthetic and saline is injected which may cause a sensation of pressure or tightness within the joint.
Afterwards, the shoulder may feel heavy or numb and you may experience a temporary increase in pain as the anaesthetic wears off. But, over time hydrodilatation can support the lessening of symptoms and, when combined with a programme of physiotherapy, help you to regain mobility in your shoulder.
If you believe you may be suffering from a frozen shoulder, it is important to get an accurate diagnosis. Once the condition is confirmed, your doctor can discuss the most effective course of treatment for you. If you would like information or advice about hydrodilatation contact us.
MUSCULOSKELETAL TREATMENT | MANCHESTER, LANCASHIRE & CHESHIRE
W27 provides fast, accurate diagnosis and treatment of musculoskeletal symptoms and conditions using the latest state-of-the-art imaging facilities. We also offer therapeutic injections to help relieve joint pain.
For your appointment there is a choice of locations:
The John Charnley Wing, Wrightington Hospital – Hall Lane, Appley Bridge, Wigan, WN6 9EP
HCA The Wilmslow Hospital – 52 Alderley Road, Wilmslow, Cheshire, SK9 1NY
Euxton Hall Hospital – Wigan Road, Euxton, Chorley, PR7 6DY
The Spire Manchester – 170 Barlow Moor Road, Didsbury, Manchester, M20 2AF
The OrthTeam Centre Ohm Building – 168 Barlow Moor Road, Manchester, M20 2AF
MedSerena Upright MRI Centre Manchester – 26-28 The Boulevard, Manchester, M20 2EU
MedSerena Upright MRI Centre London – 114a Cromwell Road, Kensington, London SW7 4ES
Information about our Fees can be found here.
If you have any questions or would like to discuss your options with a specialist, please contact the team to book an initial consultation.