Every so often in general practice, a run of patients arrive with the same complaint. A few weeks ago, it was frozen shoulder.
It’s possible that this was due to the recent drop in temperatures after an unseasonably long summer. Many frozen shoulder patients say that cold weather can trigger painful flare-ups.
One after another they sat down in front of me, having already looked up their symptoms online. And every one of them wanted the same thing: a quick fix.
A pill, an injection – anything I could do to make it go away.
I don’t blame them. Frozen shoulder hurts. Known medically as adhesive capsulitis, frozen shoulder happens when the capsule of tissue around the shoulder joint becomes inflamed, thickened and tight.
That makes it painful and stiff. It ruins sleep and gets in the way of everyday life.
But what struck me was that almost none of these patients, despite reading about the condition online, had tried to do anything to treat the pain at home.
Of course it’s the job of GPs to help patients with medical issues – no matter what it is.
Without treatment, it can take frozen shoulder up to three years to heal itself
However, frozen shoulder is one of those conditions where the power to fix the problem is in the hands of the patient – simple daily exercises, easily found online, that can make a big difference.
First, though, it’s important to explain what triggers it and who is most at risk.
Frozen shoulder often follows an injury or a spell when the arm has been kept still, such as after surgery. But in many cases there is no clear cause.
Frozen shoulder tends to happen in three stages, which can overlap. First comes the ‘freezing’ stage, when pain is the main problem and stiffness creeps in.
Then the ‘frozen’ stage, when the pain eases but stiffness is at its worst. Finally the ‘thawing’ stage, when movement slowly returns but the pain continues.
Getting over it can take between one and three years. The most important thing is to keep moving, gently.
A stretch should feel like mild tension, never sharp pain. Forcing it can cause more inflammation and make things worse. So rather than one heroic session, aim for short, frequent ones, two or three times a day.
Warm up the shoulder first. A warm shower or a heat pack for ten minutes can make movement easier.
The most important step to treating a frozen shoulder is to keep it moving, says Dr Philippa Kaye, who recommends daily stretches and exercises
Start with pendulum swings. Lean forward with your good hand on a table and let the sore arm hang loose. Swing it in small circles, then forwards and back.
Next, the table slide. Sit with your forearm on a table, palm facing down. Slowly slide it forward, leaning your body with it, as if wiping the surface clean.
Both these exercises should improve flexibility and strength in the shoulder, easing the pain.
GP, author and broadcaster Dr Philippa Kaye
Another important exercise is called wall walks. Face a wall, let your fingers climb as high as is comfortable, then mark the spot in pencil. Over the weeks that line should creep upwards, showing the progress you might not feel day to day.
If the pain is in the back of the shoulder, try a cross-body stretch – holding the sore arm at the elbow and gently drawing it across the chest.
For pain, heat helps, like a hot water bottle. Simple painkillers such as paracetamol or ibuprofen are useful too.
At night, avoid lying on the bad shoulder. And during the day, resist the urge to protect the arm – complete rest only makes it stiffer. Keep using it for ordinary tasks. If you work at a desk, take breaks to get up and move around.
If the exercises aren’t helping or the pain is severe, go back to your GP.
In extreme cases, a steroid injection might be offered but this is only a temporary measure and won’t solve the problem. The only steps that will do that are gentle daily movement and patience.
