Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Shoulder Stiffness | Research article

Living with a frozen shoulder – a phenomenological inquiry

Authors: Suellen Anne Lyne, Fiona Mary Goldblatt, Ernst Michael Shanahan

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Login to get access

Abstract

Background

Frozen shoulder (adhesive capsulitis) is an inflammatory condition affecting the capsule of the glenohumeral joint. It is characterised by a painful restricted range of passive and active movement in all planes of motion. The impact of frozen shoulder on affected individuals remains poorly characterised. In this study we sought to better understand the lived experience of people suffering from frozen shoulder to characterise the physical, psychological and socioeconomic impact of the condition.

Methods

A qualitative study using a phenomenological approach was undertaken. Purposeful sampling was used to identify individuals for interview. Semi-structured interviews were performed and continued until saturation was achieved. A biopsychosocial framework was used during the analysis in order to generate themes which best described the phenomenon and reflected the lived experience of individuals’ suffering from this condition.

Results

Ten interviews were conducted, and five main themes emerged including; the severity of the pain experience, a loss of independence, an altered sense of self, the significant psychological impact, and the variable experience with healthcare providers.

Conclusions

These findings offer an insight into the lived experience of individuals with frozen shoulder, both on a personal and sociocultural level. The pain endured has profound impacts on physical and mental health, with loss of function resulting in a narrative reconstruction and altered sense of self. Our findings illustrate that frozen shoulder is much more than a benign self-limiting musculoskeletal condition and should be managed accordingly.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hochberg MGE, Silman A, Smolen J, Weinblatt M, Weismanet M. Rheumatology: the shoulder. 7th ed. USA: Elsevier; 2018. Hochberg MGE, Silman A, Smolen J, Weinblatt M, Weismanet M. Rheumatology: the shoulder. 7th ed. USA: Elsevier; 2018.
2.
go back to reference Challoumas D, Biddle M, McLean M, Millar NL. Comparison of treatments for frozen shoulder: a systematic review and Meta-analysis. JAMA Netw Open. 2020;3(12):e2029581.PubMedPubMedCentralCrossRef Challoumas D, Biddle M, McLean M, Millar NL. Comparison of treatments for frozen shoulder: a systematic review and Meta-analysis. JAMA Netw Open. 2020;3(12):e2029581.PubMedPubMedCentralCrossRef
5.
go back to reference Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J. 2016;6(1):26–34.PubMedPubMedCentralCrossRef Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J. 2016;6(1):26–34.PubMedPubMedCentralCrossRef
6.
go back to reference Ramirez J. Adhesive capsulitis: diagnosis and management. Am Fam Physician. 2019;99(5):297–300.PubMed Ramirez J. Adhesive capsulitis: diagnosis and management. Am Fam Physician. 2019;99(5):297–300.PubMed
8.
go back to reference Jones S, Hanchard N, Hamilton S, Rangan A. A qualitative study of patients' perceptions and priorities when living with primary frozen shoulder. BMJ Open. 2013;3(9):e003452.PubMedPubMedCentralCrossRef Jones S, Hanchard N, Hamilton S, Rangan A. A qualitative study of patients' perceptions and priorities when living with primary frozen shoulder. BMJ Open. 2013;3(9):e003452.PubMedPubMedCentralCrossRef
9.
go back to reference Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013;43(5):A1–31.PubMedCrossRef Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, et al. Shoulder pain and mobility deficits: adhesive capsulitis. J Orthop Sports Phys Ther. 2013;43(5):A1–31.PubMedCrossRef
10.
go back to reference Lewis J. Frozen shoulder contracture syndrome - Aetiology, diagnosis and management. Man Ther. 2015;20(1):2–9.PubMedCrossRef Lewis J. Frozen shoulder contracture syndrome - Aetiology, diagnosis and management. Man Ther. 2015;20(1):2–9.PubMedCrossRef
11.
go back to reference Maund E, Craig D, Suekarran S, Neilson A, Wright K, Brealey S, et al. Management of frozen shoulder: a systematic review and cost-effectiveness analysis. Health Technol Assess. 2012;16(11):1–264.PubMedPubMedCentralCrossRef Maund E, Craig D, Suekarran S, Neilson A, Wright K, Brealey S, et al. Management of frozen shoulder: a systematic review and cost-effectiveness analysis. Health Technol Assess. 2012;16(11):1–264.PubMedPubMedCentralCrossRef
12.
go back to reference Page MJ, O'Connor DA, Malek M, Haas R, Beaton D, Huang H, et al. Patients' experience of shoulder disorders: a systematic review of qualitative studies for the OMERACT shoulder Core domain set. Rheumatology. 2019;58(8):1410–21. Page MJ, O'Connor DA, Malek M, Haas R, Beaton D, Huang H, et al. Patients' experience of shoulder disorders: a systematic review of qualitative studies for the OMERACT shoulder Core domain set. Rheumatology. 2019;58(8):1410–21.
14.
go back to reference Harding G, Parsons S, Rahman A, Underwood M. "it struck me that they didn't understand pain": the specialist pain clinic experience of patients with chronic musculoskeletal pain. Arthritis Rheum. 2005;53(5):691–6.PubMedCrossRef Harding G, Parsons S, Rahman A, Underwood M. "it struck me that they didn't understand pain": the specialist pain clinic experience of patients with chronic musculoskeletal pain. Arthritis Rheum. 2005;53(5):691–6.PubMedCrossRef
15.
go back to reference Carter B. Clients' experiences of frozen shoulder and its treatment with Bowen technique. Complement Ther Nurs Midwifery. 2002;8(4):204–10.PubMedCrossRef Carter B. Clients' experiences of frozen shoulder and its treatment with Bowen technique. Complement Ther Nurs Midwifery. 2002;8(4):204–10.PubMedCrossRef
17.
go back to reference Welman J, Kruger F. Research methodology for the business and adminstrative sciences. Cape Town: Oxford University Press; 1999. Welman J, Kruger F. Research methodology for the business and adminstrative sciences. Cape Town: Oxford University Press; 1999.
18.
go back to reference McGrath C, Palmgren PJ, Liljedahl M. Twelve tips for conducting qualitative research interviews. Med Teach. 2019;41(9):1002–6.PubMedCrossRef McGrath C, Palmgren PJ, Liljedahl M. Twelve tips for conducting qualitative research interviews. Med Teach. 2019;41(9):1002–6.PubMedCrossRef
19.
go back to reference Easton KL, McComish JF, Greenberg R. Avoiding common pitfalls in qualitative data collection and transcription. Qual Health Res. 2000;10(5):703–7.PubMedCrossRef Easton KL, McComish JF, Greenberg R. Avoiding common pitfalls in qualitative data collection and transcription. Qual Health Res. 2000;10(5):703–7.PubMedCrossRef
20.
go back to reference Guest G, Bunce A, Johnson L. How many interviews are enough?: an experiment with data saturation and variability. Field Methods. 2006;18:59–82.CrossRef Guest G, Bunce A, Johnson L. How many interviews are enough?: an experiment with data saturation and variability. Field Methods. 2006;18:59–82.CrossRef
21.
go back to reference Colaizzi P. In: RVaM K, editor. Psychological research as a phenomenologist views it. Existential phenomenological alternatives for psychology. New York: Oxford University Press; 1978. Colaizzi P. In: RVaM K, editor. Psychological research as a phenomenologist views it. Existential phenomenological alternatives for psychology. New York: Oxford University Press; 1978.
22.
go back to reference Creswell J. In: Oaks T, editor. Qualitative inquiry and research design: choosing among five approaches. 3rd ed: Sage Publications; 2012. Creswell J. In: Oaks T, editor. Qualitative inquiry and research design: choosing among five approaches. 3rd ed: Sage Publications; 2012.
23.
go back to reference Cohen L, Manion L, Morrison K. Research methods in education. 5th ed. London: Routledge Falmer; 2000. Cohen L, Manion L, Morrison K. Research methods in education. 5th ed. London: Routledge Falmer; 2000.
24.
go back to reference Hycner R. Some guidelines for the phenomenological analysis of interview data. Hum Stud. 1985;8:279–303.CrossRef Hycner R. Some guidelines for the phenomenological analysis of interview data. Hum Stud. 1985;8:279–303.CrossRef
25.
go back to reference Flick U. An introduction to qualitative research. 4th ed. London: Sage Publications; 2009. Flick U. An introduction to qualitative research. 4th ed. London: Sage Publications; 2009.
26.
go back to reference Groenewald T. A phenomenological research design illustrated. Int J Qual Methods. 2004;3(1):42–55. Groenewald T. A phenomenological research design illustrated. Int J Qual Methods. 2004;3(1):42–55.
27.
go back to reference Moustakas C. Phenomenological research methods. London: Sage Publications; 1994.CrossRef Moustakas C. Phenomenological research methods. London: Sage Publications; 1994.CrossRef
28.
go back to reference QSR International Pty Ltd. NVivo (released in 2018). 2018. QSR International Pty Ltd. NVivo (released in 2018). 2018.
29.
go back to reference Dowling M, Cooney A. Research approaches related to phenomenology: negotiating a complex landscape. Nurse Res. 2012;20(2):21–7.PubMedCrossRef Dowling M, Cooney A. Research approaches related to phenomenology: negotiating a complex landscape. Nurse Res. 2012;20(2):21–7.PubMedCrossRef
30.
go back to reference Nowell LSNJ, White DE, Moules NJ. Thematic analysis: striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16:1–13.CrossRef Nowell LSNJ, White DE, Moules NJ. Thematic analysis: striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16:1–13.CrossRef
31.
go back to reference Kelly M. Self, identity and radical surgery. Sociol Health Illn. 1992;14:390–415.CrossRef Kelly M. Self, identity and radical surgery. Sociol Health Illn. 1992;14:390–415.CrossRef
32.
go back to reference Yoshinda K. Reshaping of self: a pendular reconstruction of self and identity among adults with traumatic spinal cord injury. Sociol Health Illn. 1993;15:217–45.CrossRef Yoshinda K. Reshaping of self: a pendular reconstruction of self and identity among adults with traumatic spinal cord injury. Sociol Health Illn. 1993;15:217–45.CrossRef
33.
go back to reference Müller LP, Müller LA, Happ J, Kerschbaumer F. Frozen shoulder: a sympathetic dystrophy? Arch Orthop Trauma Surg. 2000;120(1–2):84–7.PubMedCrossRef Müller LP, Müller LA, Happ J, Kerschbaumer F. Frozen shoulder: a sympathetic dystrophy? Arch Orthop Trauma Surg. 2000;120(1–2):84–7.PubMedCrossRef
34.
go back to reference Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017;9(2):75–84.PubMedCrossRef Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017;9(2):75–84.PubMedCrossRef
35.
go back to reference Moseley G. Reconceptualising pain according to modern pain science. Phys Ther Rev. 2007;12:169–78.CrossRef Moseley G. Reconceptualising pain according to modern pain science. Phys Ther Rev. 2007;12:169–78.CrossRef
36.
go back to reference Eccleston C, Williams AC, Rogers WS. Patients' and professionals' understandings of the causes of chronic pain: blame, responsibility and identity protection. Soc Sci Med. 1997;45(5):699–709.PubMedCrossRef Eccleston C, Williams AC, Rogers WS. Patients' and professionals' understandings of the causes of chronic pain: blame, responsibility and identity protection. Soc Sci Med. 1997;45(5):699–709.PubMedCrossRef
37.
go back to reference Kugelmann R. The psychology and management of pain. Theory Pscyhol. 1997;7:43–65.CrossRef Kugelmann R. The psychology and management of pain. Theory Pscyhol. 1997;7:43–65.CrossRef
38.
go back to reference Smith J, Osborn M. Pain as an assault on the self: an interpretive phenomenological analysis of the psychological impact of chronic benign low back pain. Psychol Health. 2007;24:517–34.CrossRef Smith J, Osborn M. Pain as an assault on the self: an interpretive phenomenological analysis of the psychological impact of chronic benign low back pain. Psychol Health. 2007;24:517–34.CrossRef
39.
go back to reference Eccleston C. A normal psychology of chronic pain. Psychologist. 2011;24:422–5. Eccleston C. A normal psychology of chronic pain. Psychologist. 2011;24:422–5.
41.
go back to reference Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52–64.PubMedCrossRef Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52–64.PubMedCrossRef
42.
go back to reference Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev. 2003;2003(2):Cd004258.PubMedCentral Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev. 2003;2003(2):Cd004258.PubMedCentral
44.
go back to reference Ryans I, Montgomery A, Galway R, Kernohan WG, McKane R. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford). 2005;44(4):529–35.CrossRef Ryans I, Montgomery A, Galway R, Kernohan WG, McKane R. A randomized controlled trial of intra-articular triamcinolone and/or physiotherapy in shoulder capsulitis. Rheumatology (Oxford). 2005;44(4):529–35.CrossRef
45.
go back to reference Pulvirenti M, McMillan J, Lawn S. Empowerment, patient centred care and self-management. Health Expect. 2014;17(3):303–10.PubMedCrossRef Pulvirenti M, McMillan J, Lawn S. Empowerment, patient centred care and self-management. Health Expect. 2014;17(3):303–10.PubMedCrossRef
46.
go back to reference Lewis H. Shame - the 'sleeper' in psychopathology: the role of shame in symptom formation. Hillsdale: Lawrence Erlbaum Associates; 1987. Lewis H. Shame - the 'sleeper' in psychopathology: the role of shame in symptom formation. Hillsdale: Lawrence Erlbaum Associates; 1987.
47.
go back to reference Lin I, Wiles L, Waller R, Caneiro JP, Nagree Y, Straker L, et al. Patient-centred care: the cornerstone for high-value musculoskeletal pain management. Br J Sports Med. 2020;54(21):1240–2.PubMedCrossRef Lin I, Wiles L, Waller R, Caneiro JP, Nagree Y, Straker L, et al. Patient-centred care: the cornerstone for high-value musculoskeletal pain management. Br J Sports Med. 2020;54(21):1240–2.PubMedCrossRef
48.
go back to reference Geenen R, Overman CL, Christensen R, Åsenlöf P, Capela S, Huisinga KL, et al. EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018;77(6):797–807.PubMed Geenen R, Overman CL, Christensen R, Åsenlöf P, Capela S, Huisinga KL, et al. EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018;77(6):797–807.PubMed
49.
go back to reference De Baets L, Matheve T, Dierickx C, Bijnens E, Jans D, Timmermans A. Are clinical outcomes of frozen shoulder linked to pain, structural factors or pain-related cognitions? An explorative cohort study. Musculoskelet Sci Pract. 2020;50:102270.PubMedCrossRef De Baets L, Matheve T, Dierickx C, Bijnens E, Jans D, Timmermans A. Are clinical outcomes of frozen shoulder linked to pain, structural factors or pain-related cognitions? An explorative cohort study. Musculoskelet Sci Pract. 2020;50:102270.PubMedCrossRef
50.
go back to reference De Baets L, Matheve T, Traxler J, Vlaeyen J, Timmermans A. Pain-related beliefs are associated with arm function in persons with frozen shoulder. Shoulder Elbow. 2020;12(6):432–40.PubMedPubMedCentralCrossRef De Baets L, Matheve T, Traxler J, Vlaeyen J, Timmermans A. Pain-related beliefs are associated with arm function in persons with frozen shoulder. Shoulder Elbow. 2020;12(6):432–40.PubMedPubMedCentralCrossRef
51.
go back to reference Chiaramonte R, Bonfiglio M, Chisari S. A significant relationship between personality traits and adhesive capsulitis. Rev Assoc Med Bras. 1992;66(2):166–73.CrossRef Chiaramonte R, Bonfiglio M, Chisari S. A significant relationship between personality traits and adhesive capsulitis. Rev Assoc Med Bras. 1992;66(2):166–73.CrossRef
52.
go back to reference Moseley GL, Butler DS. Fifteen years of explaining pain: the past, present, and future. J Pain. 2015;16(9):807–13.PubMedCrossRef Moseley GL, Butler DS. Fifteen years of explaining pain: the past, present, and future. J Pain. 2015;16(9):807–13.PubMedCrossRef
53.
go back to reference Roter D, Hall J. Doctors talking with patients/patients talking with doctors: improving communication in medical visits. Santa Barbara: Praeger; 2006. Roter D, Hall J. Doctors talking with patients/patients talking with doctors: improving communication in medical visits. Santa Barbara: Praeger; 2006.
Metadata
Title
Living with a frozen shoulder – a phenomenological inquiry
Authors
Suellen Anne Lyne
Fiona Mary Goldblatt
Ernst Michael Shanahan
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-022-05251-7

Other articles of this Issue 1/2022

BMC Musculoskeletal Disorders 1/2022 Go to the issue