‘Painful & Stiff Frozen Shoulder – How is it successfully Treated?’

If you have Frozen Shoulder, then you are burdened with significant Shoulder pain and restriction. The Shoulder joint capsule becomes stiff and reduces shoulder movement. There are two stages that guide treatment of this condition; the initial stage ‘Pain is greater than Stiffness’ and the later stage ‘Stiffness is greater than Pain’.

Common Signs of Frozen Shoulder:

  • Restriction with Pain when reaching upwards overhead, placing hand backwards when putting on a shirt and unable to lift the arm up sideways.

  • Stiffness with Loss of movement and significant Sharp pain on some shoulder movements

  • No episode of trauma has caused the pain, the pain and restriction has come out of no where!

Treatment & Management

After diagnosing a Patient’s Shoulder pain as Frozen Shoulder, the first step would be to refer the shoulder joint for an x-ray in order to rule out any other joint pathology that may be present. Treatment of Frozen Shoulder is based on two stages, A) ’ Pain greater than Stiffness’ and B) ‘Stiffness greater than Pain’. During the stage of ‘Pain Greater than Stiffness’ in the initial weeks, there is significant Pain so the treatment protocol can involve Corticosteroid and hydro-distension injections using diagnostic ultrasound for guidance performed by an Orthopaedic Physician. The patient can then perform gentle painfree shoulder movement exercises at home as prescribed by their Physical therapist in order to encourage greater movement within painfree limits. It is important at this early ‘Shoulder Pain greater than Stiffness’ that there is communication between the Physician who administers the injection therapy and the Physical therapist. This will help the condition progress onto Stage two where the condition becomes ‘Shoulder Stiffness Greater than Pain’ In this phrase there is greater scope for success with Painfree manual treatment to achieve increased movement. Techniques such as Shoulder joint mobilisations with the shoulder placed in a painfree neutral position can be effective.

Eccentric strengthening of the rotator cuff tendons that attach to the restricted and dysfunctional shoulder capsule can be an effective treatment tool in the ‘Stiff Greater than Pain Stage’. It involves the patient attempting to relax the protective grip-like tension that they have in their wrist and shoulder which can then help to reduce pain, allow increased shoulder movement and shoulder strengthen. These exercises are carried out under the guidance of your Practitioner.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles. Contact Number: 0504 26672 Email your queries to: tomaspryan@gmail.com

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Physiotherapy & Injury Rehabilitation Clinic in Tipperary

0504 26672


The Surgery, Fianna Road, Thurles


Riverside Medical Centre, 7 Upper

Irishtown, Clonmel

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Insurers : You can receive rebates on your Physical Therapy visits.Tax relief is available on all Physical Therapy costs, Tax relief may be claimed by filling in the MED 1 form available from www.revenue.ie.

Receipts are provided after each treatment for tax or health insurance companies.