Frozen shoulder is a condition that causes pain and stiffness of the shoulder. Patients typically develop pain followed by the onset of stiffness. The condition usually goes away again, even without treatment. It can take 1-2 years for patients to go through the disease process from onset to resolution. The cause of frozen shoulder is unknown, in some patients the symptoms develop following a seemingly trivial injury. The condition results in a thickening of the joint capsule which makes it difficult to move the arm normally.
Pain is typically located on the side and the front of the shoulder and the upper arm. Patients often complain of a dull, ongoing pain that can wake them up at night. The stiffness often makes it difficult for patients to reach up higher than shoulder level.
Physiotherapy in the form of stretching exercises can help patient develop better function. Steroid injections have often been used with good success. In recent years a procedure called hydrodilatation has been very popular with high success rates. This involves the injection of a mix of local anaesthetic, corticosteroids and saline into the shoulder under pressure, followed by a course of intensive physiotherapy. Keyhole surgery to release the frozen shoulder surgically is usually considered to be the treatment of last resort. While most patients respond well to treatment, insulin-dependent diabetics are often much more treatment resistant.
At the Orthobiologics Clinic we were intrigued to see that Platelet Rich Plasma (PRP) was shown in research trials to be an effective alternative in the treatment of frozen shoulder. We see this as a particularly promising option for diabetic patients, who often experience problems with their blood sugar control after any treatment involving the injection of corticosteroids. The increasing concerns over the potential long-term detrimental side effects of corticosteroid injections makes injection treatment with PRP an interesting alternative treatment option for any patients who may have reservations over the use of corticosteroids. Our specialists at the Orthobiologics Clinic are happy to discuss the advantages and drawbacks of the various treatment options with patients affected by frozen shoulder.
