Participants experiences of living with frozen shoulder

• Research type

  Research Study

• Full title

  Participants experiences of living with frozen shoulder: A qualitative review

• IRAS ID

  274953

• Contact name

  Christine Bilsborough Smith

• Contact email

  christinebilsborough@nhs.net

• Sponsor organisation

  Central London Community Healthcare NHS Trust

• Duration of Study in the UK

  years, 2 months, days

• Research summary

  Research Summary

  A common cause of shoulder pain is a gradual stiffening of the shoulder known as frozen shoulder and affects between 2-5% of the population. Activities of daily living, such as dressing, attending to personal hygiene are often associated with substantial pain and morbidity, with some leaving work due to the symptoms.

  The causes of frozen shoulder are poorly understood, however it appears to be more common in people with diabetes. Frozen shoulder typically goes through two stages. Stage 1: pain greater than stiffness and stage 2: stiffness greater than pain. In stage 2, research has demonstrated some benefit for exercise and physiotherapy in the management of frozen shoulder.

  The study aims are:

  • To explore participants experiences of living with frozen shoulder in terms of symptoms, obtaining a diagnosis and receiving management.

  • To explore the impact the condition has on social and occupational factors
  • How the patients were involved in shared decision making

  Eligibility criteria

  • A primary diagnosis of idiopathic or secondary systemic (associated with diabetes) frozen shoulder who have been referred by their GP, orthopaedic consultant or similar qualified healthcare professional.

  Method

  A single semi-structured interview, lasting no more than 60 minutes, will be conducted at a location agreed with the participant. Either at the participants home, a patient interview room within the community hospital setting or via teleconference.*

  Potential participants will be identified via the NHS community musculoskeletal pathway for patients with frozen shoulder and will have completed their episode of care. This is an established care pathway for frozen shoulder within Central London Community Healthcare NHS Trust in the London Borough of Barnet. Patients are referred by their GP, orthopaedic consultant or other appropriate healthcare professional with an initial diagnosis of frozen shoulder. This is a single site study.

  *Dependent upon current COVID situation.

  Summary of Results

  Frozen shoulder is a disabling condition characterised by severe pain and loss of shoulder movement and may affect up to 5% of the population. Qualitative research documents debilitating pain and how treatment to reduce pain is a priority for people diagnosed with frozen shoulder. Corticosteroid injections are a principal treatment to reduce the pain of frozen shoulder, however little is known about the patient experience.

  Objectives
  This study aims to address this gap in the knowledge by exploring the lived experience of people with frozen shoulder who have undergone an injection and to highlight other novel findings.

  Design
  This is a qualitative study using interpretative phenomenological analysis. One-to-one, semi-structured interviews were conducted with seven people diagnosed with frozen shoulder who had received a corticosteroid injection as part of their management.

  Methodology
  A purposive sample of participants were interviewed via MSTeamsTM due to Covid-19 restrictions. Data was collected through semi-structured interviews and analysed in accordance with interpretive phenomenological analysis methods

  Results
  Three group experiential themes were identified: the dilemma surrounding injections; the challenges of understanding the causes of frozen shoulder; the impact on self and others.

  Conclusion
  Participants conveyed a strong desire in seeking a corticosteroid injection whilst seemingly dismissing the risks. A novel concept was illuminated as frozen shoulder seemed inextricably linked with the ageing process, which negatively impacted body-image. The impact on others is driven by a sense of the unfamiliar nature of illness and it is incumbent on healthcare professionals to seek opportunities to explore the individual’s beliefs.

• REC name

  South Central - Oxford C Research Ethics Committee

• REC reference

  20/SC/0278

• Date of REC Opinion

  21 Aug 2020

• REC opinion

  Further Information Favourable Opinion