<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> frozen shoulder is a common cause of shoulder pain. most common in middle-aged females. aetiology of frozen shoulder is not fully understood. ''Associations'' diabetes mellitus: up to 20% of diabetics may have an episode of frozen shoulder thyroid overactive disease ''Features'' //external rotation// is affected more than internal rotation or abduction both active and passive movement are affected patients typically have a painful freezing phase(2-9/12) pain esp at night, an adhesive phase(4-12/12) mvt increasingly restricted and a recovery phase (1-3yrs) - may not resolve completely bilateral in up to 20% of patients ''Management'' no single intervention has been shown to improve outcome in the long-term Xray to exclude other problems treatment options include NSAIDs, physiotherapy, oral corticosteroids and intra-articular corticosteroids ''Injections'' Posterior approach - 1 cm below 'soft spot' on lateral side of acromion (scapula spine) heading for coracoid process Anterior approach - (more accurate, more scary for patient as they can see the needle) - 1cm below clavicle and between less trochanter (medial side of of humoral head) and coracoid - and aim for acromion soft spot.