Frozen Shoulder Treatment Singapore

Dr. Bryan Tan

MBBS (SINGAPORE) MMED (ORTHO) FRCS ED (ORTH)

Frozen shoulder is a condition in which the capsule of the joint becomes inflamed, thickened and stiff, hence severely restricting movements of the joint.

Patients with this condition are often middle-aged or elderly. It is vital to understand your symptoms and seek medical treatment as soon as possible, as early diagnosis and management can reduce the complications of frozen shoulder.

What Is a Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is one of the most common shoulder problems seen in Dr. Bryan’s clinical practice. It is estimated to affect 2% – 5% of the general population, and 20% of patients with diabetes.

Because the entire area extending from the base of the neck, to the tip of the shoulder, both front and back can be considered “the shoulder”, there are often many conditions that can present with “shoulder pain”. Generally, the cause of the pain can be localised to either a cervical spine (neck) problem or a shoulder joint problem.

Some shoulder problems may be mainly sport specific and may only occur during over movements like over tennis serves, badminton smashes, volleyball spikes or throwing a ball. Others may occur during gym work outs like bench presses or shoulder presses. 

What Causes Frozen Shoulder?

Frozen shoulder occurs when the capsule (covering of the shoulder joint) thickens and tightens, restricting the shoulder’s movement.

While the exact causes of frozen shoulder are unknown, the following factors and conditions are known to increase the risk of developing frozen shoulder:

  • Age (40 years and older)
  • Prolonged immobility of the shoulder
  • Rotator cuff injury
  • Recovery from surgery
  • Broken or fractured arm
  • Diabetes
  • Thyroid disorders
  • Cardiovascular diseases
  • Tuberculosis
  • Stroke

Symptoms Of Frozen Shoulder

The 2 most common symptoms that patients experience are pain and stiffness of the shoulder, and limited mobility. The pain is typically felt on the arm, underneath the deltoid muscle.

Others may report an often mild and somewhat insignificant “injury” like having a slight jerk while taking the train or feeling a mild twinge of discomfort while reaching out for something. The pain then slowly becomes more noticeable over the course of a few weeks to months.

The intensity of pain may vary between different patients. In some patients, the pain is mild and is more of a niggling irritating discomfort. But in some patients, the pain may be severe and interfere with activities of daily living.

Many patients also experience stiffness of their shoulders. The most severely affected movement is often internal rotation. Many male patients will report that they are unable to place their wallets in the back pocket of their pants while ladies will find that they are unable to reach behind their backs to clasp their bra.

Many patients will also experience weakness of their arms but this is often due to pain when trying to lift loads or trying to move beyond the range possible for their stiff shoulders.

How Is Frozen Shoulder Diagnosed?

Your doctor will physically examine your shoulders to check for symptoms such as pain or joint stiffness as well as test the shoulder’s range of motion and mobility.

Additional diagnostic tests may also be performed to obtain further information on the shoulder joints or to rule out other possible problems:

  • X-rays can reveal problems in the shoulders, such as arthritis.
  • MRI scans provide more detailed images of the shoulder joints to help identify other problems, such as a torn rotator cuff.
Is your frozen shoulder affecting your quality of life, and your ability to perform everyday activities such as working, playing sports and wearing your clothes?
Dr. Bryan will assess your symptoms in detail before recommending the right treatment plan for your condition.

How Is Frozen Shoulder Treated?

Treatment of frozen shoulders depend on the phase at which the patients present. Generally, treatment comprises pain relief and physiotherapy.

Most frozen shoulders will resolve with time and noninvasive treatment modalities as described above. However, not all do. For cases that fail to improve, invasive treatment options may be required.

Common non-surgical treatment methods include:

  • Taking over-the-counter pain relievers, such as aspirin, ibuprofen or etoricoxib, can help reduce pain and inflammation
  • Physical therapy
  • Corticosteroid injections
  • Joint distension or injecting sterile water into the joint capsule to stretch and tear the tissue and improve mobility

Surgery may be recommended if your symptoms worsen or if non-surgical treatment options are ineffective.

Some of the common surgical treatment options include:

  • Manipulation under anaesthesia. This procedure involves moving your shoulder joints in different directions to tear the tightened tissue, so as to increase the shoulder’s mobility. Shoulder manipulation is typically performed under general anaesthesia.
  • Surgery. Surgery for frozen shoulder rapidly relieves pain and restores shoulder mobility. Surgery is typically conducted arthroscopically, where your doctor will create 2 small incisions around your shoulder before inserting a camera into the shoulder joint, allowing the thickened capsule to be divided under direct vision. It is a very safe and effective treatment for frozen shoulders.

Anatomy of the Shoulder Joint

The shoulder joint is made up of 3 bones: the shoulder blade (scapula), the humeral head and the collar-bone (clavicle).

Movements around the shoulder involve 3 separate articulations: the glenohumeral joint, the acromioclavicular joint and the scapulothoracic articulation. When the arm is raised, the majority of movement occur at the glenohumeral joint and the scapulothoracic articulation.

The glenohumeral joint is a ball and socket joint, comprising the socket (the glenoid) and the ball (the humeral head). Both surfaces of the joint are covered with an extremely smooth and rubbery cartilage (known as articular cartilage).

The smooth surfaces create a frictionless articulation when lubricated with a small amount of joint fluid. The glenohumeral joint is housed within a strong covering known as the capsule. The capsule keeps the joint separate from the surrounding tissues like muscles.

In normal, healthy shoulders, the capsule has a pale pearly appearance, and is rather thin (1-2mm perhaps).

Frequently Asked Questions

What kind of invasive treatments are there?
Is frozen shoulder serious? When should I visit a doctor?
Can frozen shoulders be prevented?
What will the doctor do?
What tests can be done to confirm the diagnosis?

Billing & Payment

Medisave & Insurance Claims

The following are accredited For Singaporeans, Singapore Permanent Residents and Foreigners. If your insurance is not listed, you will still be able to make claims for eligible procedures! We have experience processing claims from many other various insurance providers. Please contact us if you have any queries.

WHAT’S THE FIRST STEP?

Embark on Your Road to Recovery With Dr Bryan Tan

OrthoSports: Dr. Bryan Tan's Clinic
STEP 1

Book An Appointment
With Dr. Bryan

Our friendly clinic staff will assist you with your registration, ensuring an efficient and hassle-free process for you. Fill up this form to schedule an appointment with Dr. Bryan.

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STEP 2

Initial Consultation & Diagnosis of your Condition

During your consultation, Dr. Bryan will evaluate your medical history and the pain you are experiencing. You may also ask Dr. Bryan any questions you may have about your condition.

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STEP 3

Treatment & Follow Up Visits With Dr. Bryan

After your consultation with Dr. Bryan, our friendly clinic staff will assist you with your follow-up appointment, and provide you with instructions/information for any prescribed treatment plans from Dr. Bryan.

Take the First Step

Book An Appointment

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Visit our Clinic

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