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    Case History Frozen Shoulder

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    Saliha Akram
    The patient, a 58-year-old male machinist, presented with an eight week history of left shoulder pain similar to a previous frozen shoulder that had failed conservative management. Examination found reduced range of motion and pain on tests. He was managed conservatively with pain medication, postural correction, exercises, and injection, which led to significantly reduced pain after eight weeks. Over ten months his range of motion improved, pain resolved, and he was able to self-manage without further intervention. The case demonstrates that conservative management can successfully treat prolonged frozen shoulder even without frequent physiotherapy once patients learn self-management.

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    Case History Frozen Shoulder

    Uploaded by

    Saliha Akram
    395 views2 pages
    The patient, a 58-year-old male machinist, presented with an eight week history of left shoulder pain similar to a previous frozen shoulder that had failed conservative management. Examination found reduced range of motion and pain on tests. He was managed conservatively with pain medication, postural correction, exercises, and injection, which led to significantly reduced pain after eight weeks. Over ten months his range of motion improved, pain resolved, and he was able to self-manage without further intervention. The case demonstrates that conservative management can successfully treat prolonged frozen shoulder even without frequent physiotherapy once patients learn self-management.

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    Case history

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    Case History Frozen Shoulder (2) (1)

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    The patient, a 58-year-old male machinist, presented with an eight week history of left shoulder pain similar to a previous frozen shoulder that had failed conservative management. Examination found reduced range of motion and pain on tests. He was managed conservatively with pain medication, postural correction, exercises, and injection, which led to significantly reduced pain after eight weeks. Over ten months his range of motion improved, pain resolved, and he was able to self-manage without further intervention. The case demonstrates that conservative management can successfully treat prolonged frozen shoulder even without frequent physiotherapy once patients learn self-management.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    395 views2 pages

    Case History Frozen Shoulder

    Uploaded by

    Saliha Akram
    The patient, a 58-year-old male machinist, presented with an eight week history of left shoulder pain similar to a previous frozen shoulder that had failed conservative management. Examination found reduced range of motion and pain on tests. He was managed conservatively with pain medication, postural correction, exercises, and injection, which led to significantly reduced pain after eight weeks. Over ten months his range of motion improved, pain resolved, and he was able to self-manage without further intervention. The case demonstrates that conservative management can successfully treat prolonged frozen shoulder even without frequent physiotherapy once patients learn self-management.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    CASE HISTORY: FROZEN SHOULDER – CONSERVATIVE MANAGEMENT

    Patient: Male Machinist, aged 58

    Eight week history of left shoulder pain. Insidious onset. Previously had frozen
    shoulder on his right four years ago. Symptoms felt the same. Had failed
    physio/conservative management last time and ended up having a manipulation
    under anaesthetic. Took a few years to completely resolve, although MUA improved
    his movement significantly. Worried he may have to go through the same with his left
    shoulder.

    Aggravating factors
    Putting on a shirt
    Reaching for his wallet in his back pocket
    Sleeping in any position at night – having to sleep intermittently in a chair
    Reaching into cupboards

    Interventions pre assessment


    Single injection six weeks previous which had little effect
    Ongoing NSAIDs

    Past Medical History


    MUA as above for previous right frozen shoulder
    Raynaud’s disease
    Depression
    Vertigo
    High cholesterol and blood pressure

    Examination
    Poor posture, increased thoracic kyphosis and poor scapular position. No wasting,
    heat, redness or swelling.

    Reduced ROM in all directions - flexion 80°, abduction 80°, lateral rotation 10°.
    Unable to put his hand behind his back.

    Pain on all cuff and impingement tests but no obvious weakness.

    Management
    GP
    • Cocodamol
    • Diclofenac
    • Xray - NAD

    Community Physiotherapy
    • Pain management
    • Postural correction
    • Gentle polishing exercises
    • Encouraged to ice his shoulder x 20 mins up to every hour
    • Advice re activity modification

    After six weeks


    Continued to struggle with pain at night and when exercising. Was still at work and
    unable to modify his job. Patient reviewed by an extended scope practitioner who re-
    injected.
    After eight weeks
    Pain significantly reduced. Now sleeping at night and comfortable at work although
    movement restricted. Compliant with exercises. Now doing more capsule stretches
    into resistance but not pain.

    After three months


    Pain completely resolved. Range of movement – flexion 120°, abduction 100°,
    Lateral rotation 30°. No problems getting dressed or sleeping at night.
    Continuing with capsule stretches independently.

    After eight months


    Huge improvement in range of movement and function. More confident it will fully
    resolve. Flexion 160°, abd 160°, lateral rotation 50 degrees

    After ten months


    Nearly full range of movement regained. No further input required and patient is self-
    managing.

    Learning
    • It is possible to get good results with conservative management even with
    prolonged high irritability.
    • Adhesive capsulitis in most cases is self-limiting. Once pain can be controlled the
    patient can start to manage their symptoms.
    • Education about the nature process of adhesive capsulitis is key at every stage.
    Fear avoidance and guarding only prolongs recovery.
    • If patients fail to respond after six months, then surgical review would be
    indicated. It was not required in this case.
    • Although in this case the patient was seen regularly by the physiotherapy service,
    it is not always necessary. Once patients are happy with their exercises and
    capsule stretches they can normally self manage.

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