What is Frozen Shoulder?
Frozen shoulder, also called adhesive capsulitis, is a painful condition in which the movement of the shoulder becomes restricted. Frozen shoulder occurs when the ligaments surrounding The shoulder joint swell and get stiff and result in restricting the mobility. Usually, people are diagnosed with the problem in only one of their shoulders, but sometimes it may affect the ligaments in both shoulders.
Frozen shoulder occurs when the strong tissue surrounding the shoulder (called The shoulder joint capsule) become thick, stiff, and inflamed. The condition is called ‘frozen’ shoulder because the more pain that is felt, the less likely the shoulder will be used. Lack of use causes the shoulder capsule to thicken and becomes tight, making the shoulder even more difficult to move — it’s ‘frozen’ in its position.
Who is at risk for developing frozen shoulder?
- Age: Affects adults between the ages of 40 and 60, but this condition can occur at any age.
- Gender: More common in women than men.
- Diabetes: People with diabetes are twice as likely to develop frozen shoulder than people without diabetes. Those with diabetes are also more likely to develop severe symptoms that are more difficult to treat.
- Other health diseases and conditions: Dupuytren’s contracture (a tissue disorder in the hands that causes fingers to bend) are at an increased risk of frozen shoulder, calcific tendonitis and rotator cuff tear , after an injury, overuse, heart disease, stroke, hypothyroidism (underactive thyroid gland), hyperthyroidism (overactive thyroid gland), Parkinson’s disease etc.
What are the signs and symptoms of frozen shoulder?
Symptoms of frozen shoulder are divided into three stages:
1. The ‘freezing’ stage:
The shoulder becomes stiff and is painful to move. The pain slowly increases. It may worsen at night. Inability to move the shoulder increases. This stage lasts 6 weeks to 9 months.
2. The ‘frozen’ stage:
In this stage, pain may lessen, but the shoulder remains stiff. This makes it more difficult to complete daily tasks and activities. This stage lasts 2 to 6 months.
3. The ‘thawing’ (recovery) stage:
In this stage, pain lessens, and ability to move the shoulder slowly improves. Full or near full recovery occurs as normal strength and motion return. The stage lasts 6 months to 2 years.
How is frozen shoulder diagnosed?
To diagnose frozen shoulder, your doctor will:
- a.) Discuss your symptoms and review your medical history.
- b.) Conduct a physical exam of your arms and shoulders:
- – The doctor will move your shoulder in all directions to check the range of motion and if there is pain with movement. This type of exam, in which your doctor is moving your arm and not you, is called determining your“passive range of motion.”
- – The doctor will also watch you move your shoulder to see your “active range of motion.”
- – The two types of motion are compared. People with frozen shoulder have limited range of both active and passive motion.
- c.) Imaging tests, such as X-rays, magnetic resonance imaging (MRI) and ultrasound, are usually not needed to diagnose frozen shoulder. They may be taken to look for other problems, such as arthritis.
What are the treatments for frozen shoulder?
The aim of treatment for frozen shoulder is to alleviate pain and preserve mobility and flexibility in the shoulder. However, recovery may be slow, as symptoms tend to persist for several years. If the problem persists, therapy and surgery may be needed to regain motion if it doesn’t return on its own.
Some simple treatments include:
- 1. Hot and cold compresses. These help reduce pain and swelling.
- 2. Medicines that reduce pain and swelling. These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), and acetaminophen (Tylenol). Other painkiller/anti-inflammatory drugs may be prescribed by your doctor. More severe pain and swelling may be managed by steroid injections. A corticosteroid, such as cortisone, is injected directly into The shoulder joint.
- 3. Physical therapy. Stretching and range of motion exercises taught by a physical therapist.
- 4. Home exercise program. Continue exercise program at home.
- 5. Transcutaneous electrical nerve stimulation (TENS). Use of a mall battery-operated device that reduces pain by blocking nerve impulses.If these simple treatments have not relieved pain and shoulder stiffness after about a year trial, other procedures may be tried. These include:
- 6. Shoulder manipulation – The shoulder joint is gently moved while you are under a general anesthetic (a drug that makes you completely unconscious).
- 7. Shoulder Arthroscopy Surgery: Your doctor will cut through the tight parts of your joint capsule (capsular release). Small pencil-sized instruments are inserted through small cuts around your shoulder.
These two procedures are often used together to get better results.
What’s the outlook for frozen shoulder?
Simple treatments, such as use of pain relievers and shoulder exercises, in combination with a cortisone injection, are often enough to restore motion and function within a year or less. Even left completely untreated, range of motion and use of the shoulder continue to get better on their own, but often over a slower course of time. Full or nearly full recovery is seen after about 2 years.
Can frozen shoulder be prevented?
The chance of a frozen shoulder can be prevented or at least lessened if physical therapy is started shortly after any shoulder injury in which shoulder movement is painful or difficult. Your orthopaedic doctor or physical therapist can develop an exercise program to meet your specific needs.