Doctor Says

Don't shrug off 'frozen' symptoms

The pain you have in the left shoulder with certain arm movements is called shoulder impingement pain.

There is a strong and broad tendon in the shoulder called the rotator cuff. When there is an injury to the tendon, it may tear or swell.

Rotator cuff injuries range from a partial tear to a tear that spans the full thickness of the tendon. Sometimes, the body deposits calcium salts into the damaged tendon from the inflammatory response.

All this leads to pain, which typically gets worse with certain arm movements. Sleeping on the affected side also makes the pain worse. With time, if left untreated, the shoulder may stiffen, creating the so-called frozen shoulder.

It is important to resolve the problem before this stage, as recovery can become more protracted after a frozen shoulder develops.

In this condition, the ligamentous lining of the shoulder, which is normally quite loose, gets contracted and scarred. This restricts the free movement of the shoulder joint. The severity of the contraction increases over time and makes the shoulder increasingly stiff.

Shoulder and neck problems frequently co-exist in middle-aged people. So the two general practitioners you have consulted are right, in one way or other.

A careful history-taking and physical examination will clue the doctor in on the predominant problem.

Tests can help to confirm the diagnosis. You may be treated with medication, physiotherapy, steroid injections or arthroscopic surgery.

After the treatment and rehabilitative therapy, one can expect good shoulder function. Keeping joints supple with stretching, doing a variety of sports to reduce repetitive overuse of sets of muscles, and exercising with common sense will go a long way in reducing the need to see a sports or orthopaedic doctor.

•Dr Liang Te Shan, orthopaedic surgeon, an associate member of Surgeons International Holdings

A version of this article appeared in the print edition of The Straits Times on August 25, 2015, with the headline 'Don't shrug off 'frozen' symptoms'. Print Edition | Subscribe