How Come We Never Hear of this Painful Affliction that Many Kiwis (Mostly Women) Get Each Year?!

It started off as a niggle – just a little twinge in my right shoulder, which I barely gave a second’s thought to, given I had just moved house after a stressful few months.

Surely, if I just left it alone for a while, it would calm down on its own. How bad could it be? But when it was still hanging around a month later, and getting worse, I went to see a physio.

A few scans and appointments later, it was decided I had bursitis – a fairly common affliction that involves inflammation of the bursa (a little fluid filled sac that’s supposed to stop friction between the bones in your joints).

All going to plan, it would be over reasonably quickly, so I started taking ibuprofen, did my physio exercises three times a day, and waited to start feeling better.

A month later, I wasn’t feeling any better.

In fact, it was getting a lot worse. By then it was impossible to reach behind my back to do up my bra, I couldn’t hold my arm up on the steering wheel, and I was in pain all the time, particularly when I tried to sleep.

Changing my physio exercises each week seemed to be doing nothing, so I got a second opinion, and thank goodness I did. After 15 minutes of twisting (well, trying to) and prodding, he sighed and said, “I think you might have a frozen shoulder. They’re pretty painful.”

Hurrah, a diagnosis! Surely now I will be on the mend, I thought.

That is, until I got into my car, Googled it, and realised this was very much not a “hurrah” moment – it seemed most people take two whole years to “unfreeze” their shoulder and yes, it can be very painful.

Despite the fact it’s thought that between 2 and 10 per cent of New Zealanders will experience it at some point in their lives, it was the first time I had heard of a frozen shoulder.

No-one is entirely sure what causes it, although women, and those between 40 and 60 are more prone to it.

Most of the time there’s no direct cause, but it can sometimes be linked to long periods of immobilisation (such as after breast cancer), and you are much more likely to suffer from it if you have diabetes or a thyroid condition.

Officially known as adhesive capsulitis, it occurs when the strong connective tissue surrounding the shoulder joint (the capsule) becomes thick, stiff, and inflamed.

What starts as a painful, aching shoulder, leads to a loss of mobility in the joint.

The shoulder joint is actually the most mobile joint in the body, a fact you only begin to appreciate once it’s rendered immobile.

Normally, it has a tremendous range of motion – from abduction to flexion to extension, to internal rotation, and a full 360-degree circumduction of the sagittal plane. With a frozen shoulder, you lose nearly all of that motion over a few months.

The entire process takes place over three stages.

The first is the most painful stage, also known as the freezing stage, which is where the capsule changes and stiffens. You then move into the frozen stage where you have less pain but complete stiffness, which is followed by the thawing stage, characterised by little pain and a gradual return of range of movement.

Even a little movement like this one is IMPOSSIBLE with a frozen shoulder. Sigh

Each stage can vary in length, with the thawing stage often the longest, but most cases take 12 to 36 months to resolve themselves.

Armed with this information, I tried to look on the bright side – at least I was in the most painful stage and it could only get less painful from here.

Unfortunately, I didn’t realise that the pain actually continues to progress until you reach the frozen stage, a fact I soon learnt when I went away for the weekend with friends, and while sitting by the fire, texting, I suddenly felt as though a carving knife had been plunged into my shoulder and was slowly being dragged down my arm.

It was so painful, I was rendered speechless. The only giveaway being the welling of tears in my eyes, and the pale sheet-like colour my face suddenly went.

Over the next few weeks, any slight jerk or bump would cause pain that felt as though my arm was being ripped from my body.

I wondered if I was being a big wimp, until I explained over a lunch meeting that I had a frozen shoulder (to excuse why I looked like a 4-year-old trying to feed herself), and one of the women said, “oh my God, I’ve had that and I swear it was more painful than giving birth to either of my children”.

Part of the dilemma in New Zealand for getting a diagnosis, or adequate pain relief, is the fact that the number of orthopedic assessments is on the rise, paired with a shortfall of specialists, so there are lengthy waiting times for initial consultations to start getting some treatment.

When I finally saw a specialist, they explained that while there is really nothing that can be done to cure or speed up the process of it, there are two procedures that can be done to alleviate the pain and attempt to give a little more range of movement. I asked to be signed up for both, and was booked into the next slot available in Auckland, three weeks later.

The first was a steroid shot, where a needle is inserted into the joint and you then immediately, or within the following two weeks (as I experienced), feel a significant reduction in pain. This was a true godsend.

The other procedure, which has a more mixed success, is called shoulder hydrodilatation and, honestly, if you’re going to get it done, the less you know the better.

For those who aren’t squeamish, it involves another needle, to inject saline into the capsule itself in an attempt to stretch it, with the greatest outcomes coming from actually rupturing the capsule.

It is very unpleasant, most of all because the exact position you have to be in for the radiologist to gain access to the joint is the same one that causes cramping and searing pain.

But, for something that only takes about 20 minutes, it’s well worth the pain.

A few months on, I’m in a lot less pain, and can even use my right arm while driving again, but I have accepted that I won’t be reaching up to open any kitchen cupboards this year.

If you suspect you or someone you love may have the early signs of a frozen shoulder, I couldn’t encourage you more to get it checked out as soon as possible.

It can be a debilitating affliction, so the sooner you can see a specialist or be referred for a steroid shot, the less pain you will have to deal with.

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