Frozen shoulder

It may be the season for ice creams, but one thing you don't want frozen in summer - or any time of year - is your shoulder. Otherwise known as 'adhesive capsulitis of the shoulder', a frozen shoulder can be very painful, as well as limiting your ability to function normally. Most common in your 40s to 60s, frozen shoulder affects about one in 30 people at some point. Oddly, it most commonly affects the arm you don't write with.
Frozen shoulder symptoms can last for two to three years. They tend to start with a 'freezing up' phase, when your shoulder becomes painful and gradually more and more stiff. In phase two, the 'frozen' phase, the pain often gets better but stiffness can get worse, until you can hardly move your shoulder. Twisting your shoulders outwards (eg to put your hands behind your head) can be especially difficult. Finally comes the 'thawing' phase as the pain eases and movement gradually gets back to normal. Each phase can last several months.
On the plus side, there are several treatments to ease symptoms and lightning - or at least freezing - rarely strikes the same shoulder twice.
What causes a frozen shoulder?
Your shoulder joint is lined with a thin protective capsule. Doctors aren't sure exactly why scar tissue can build up in the capsule, causing it to thicken, stiffen and shrink.
How can I help myself?
Shoulder pain and strains are very common - partly because the shoulder is such a complicated joint, with a 'cuff' of strong connective tissue and lots of muscles which allow it to move in every direction. There's a lot to go wrong! Not all shoulder pains end up with a frozen shoulder. If you get shoulder pain, it's important to move your shoulder in all directions several times a day to cut the risk of it stiffening up. Your doctor can advise on exercises
What are the treatments?
Painkillers like paracetamol (with codeine if necessary) can help relieve pain. So can anti-inflammatory tablets or gels containing ibuprofen or naproxen, which will cut inflammation as well. Warm or cold compresses (never apply ice directly on to your skin) may also ease symptoms. If your symptoms don't settle quickly or seem to be getting worse, your doctor may refer you to a physiotherapist. They can give you regular exercises and may offer a TENS machine, which provides tiny electrical currents that can help with pain. A steroid injection into the joint, while not a permanent cure, can cut pain and inflammation for several weeks.
Surgery for frozen shoulder
If your shoulder is still causing problems despite proper courses of other treatment, you may be offered one of two kinds of surgery, both under general anaesthetic. The first involves moving your shoulder in all directions, to break down the scar tissue. The second is keyhole surgery using an 'arthroscope' - your surgeon will stretch the shoulder capsule and remove scar tissue. In both cases you'll be offered follow-up physiotherapy to keep it mobile.
Doing the dislocation
Your shoulder is a 'ball and socket' joint and the socket (at the top outer corner of your shoulder blade) is very shallow. That means it's relatively easy to push the ball out of the socket in a heavy fall. About 95% of shoulder dislocations are anterior - the ball at the top of the humerus (upper arm bone) is pushed forwards. Sporting injuries are the most common cause in younger people, while in older people it's mostly a fall on to an outstretched arm. You can't fail to notice it - your shoulder will be very painful, you won't be able to move it and you may see a lump. Take yourself straight to A&E for an X-ray to check no bones are broken, and the doctor will manipulate it back into place under sedation. You'll need to wear a sling for a few weeks and see a physiotherapist regularly. You'll feel better within a couple of weeks but complete recovery can take up to four months.