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MEDICAL MATTERS Frozen Shoulder
Leading consultant orthopaedic surgeon Simon Moyes discusses a revolutionary new technique to combat the pain of frozen shoulder
As REPs members you may have encountered many people in your daily work with the medical condition, frozen shoulder.
Frozen shoulder – also known as adhesive capsulitis – is estimated to affect up to one in 20 people and is one of the most common causes of intrinsic shoulder pain. It is where the connective tissue surrounding the glenohumeral joint of the shoulder becomes inflamed and stiff, leading to a reduction in the amount of movement a person has around their shoulder joint. Most people who get frozen shoulder are 40-60 years old and the most common
symptoms are inflammation, pain and stiffness in the shoulder. People with diabetes, lung and heart disease, and sports injuries are at a higher risk of developing frozen shoulder.
“There are three main stages to frozen shoulder,” according to Simon. “First there is the initial pain, then pain and stiffness, and finally just stiffness. It usually takes between 18 and 24 months to recover.” Simon explains that, “Until recently, treatments have been limited to ice or heat pain relief, anti-inflammatories, physiotherapy and surgery.”
However, a new technique is now available, currently being pioneered by Simon and his colleague, Dr Syed Babar, called hydrostatic distension.
Simon continues, “It involves administering two injections, two weeks apart, under ultra-sound guided conditions as an out- patient. Syed and I have treated about 120 patients and 80 per cent are pain free after a month. The process is quite straight- forward, quick (approximately 10 minutes) and is combined with physiotherapy. Patients may feel a slight discomfort but no more than when receiving a local anaesthetic.”
Simon added, “The shoulder is initially assessed clinically, followed usually by an MRI scan. Then a mixture of local anaesthetic, saline and a small amount of steroid is injected into the glenohumeral joint. The joint is re-inflated, breaking down the adhesions and distending the capsule.”
Recovery time is in the order of four weeks, although patients begin to feel relief almost instantaneously, after their first injection.
THE AUTHOR Simon Moyes is a consultant orthopaedic surgeon based at The Wellington Hospital
in London specialising in keyhole or arthroscopic surgery. For more information, about hydrostatic distension or problems relating to the knee, shoulder, foot and ankle, or visit www.simonmoyes.com / www.shoulder-arthroscopy.co.uk
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