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Frozen Shoulder
Frozen shoulder is a medical condition that causes stiffness and pain in the shoulder joint as its main symptom. It is usually a temporary condition, with pain appearing gradually at first, then getting worse and finally reducing and disappearing. The time between its initial appearance and its final resolution can take between one and three years. The technical name for frozen shoulder is adhesive capsulitis. It is more likely to appear when the patient is undergoing treatment for another condition that prevents him or her from moving the affected arm. Frozen shoulder treatment may include exercises to increase the joint’s range of motion as well as possibly corticosteroids and arthroscopic surgery.
Frozen Shoulder Causes & Risk Factors
The shoulder joint includes a network of bones, ligaments and tendons that are enclosed in a connective tissue capsule. Under certain conditions, this capsule can thicken and tighten around the joint, resulting in restricted movement.
The underlying causes for the development of frozen shoulder are not clear. However, there is a correlation between the incidence of diabetes and that of frozen shoulder.
In addition, as mentioned above, it is more likely to appear in individuals who have had to restrict shoulder movement for a protracted period of time. This is particularly the case for individuals over the age of 40 or who are female. As stated, the reasons for this are unclear.
Other factors that may cause this restriction of shoulder movement and trigger frozen shoulder problems may include:
- Rotator Cuff Injuries;
- Arm Fracture;
- Stroke;
- Rehabilitation from a surgical procedure;
- Under or over active thyroids;
- Cardiovascular disease;
- Tuberculosis; and
- Certain neurological conditions like Parkinsons’ Disease.
Symptoms
As mentioned earlier, fr4ozen shoulder symptoms start gradually rather than suddenly appearing as a result of some specific incident.
- In the first stage (freezing), the patient experiences decreased shoulder range of motion with any attempt at moving the joint producing pain. For some patients, this pain can become worse during nighttime;
- In the second stage (frozen), the pain may decrease but the patient may experience stiffness in the shoulder and even greater difficulty moving the joint;
- Finally, in the third stage (thawing), the patient recovers shoulder range of motion and the pain gradually disappears.
Each of these stages may last up to several months.
Treatment & Prevention
Treatment of a frozen shoulder usually focuses on controlling the pain and preserving as much range of motion as possible until the condition runs its course:
For pain control the patient can use an over the counter medication like aspirin. If the pain is severe and does not respond to non prescription medication, doctors may suggest non steroidal anti inflammatory drugs to control it.
As explained above, this condition tends to resolve on its own in around 1-2 years. However, if it does not, more aggressive intervention approaches may be necessary. These may include:
- Steroid injections, which can help to reduce pain and improve shoulder range of motion, especially if done in the early stages of frozen shoulder;
- Injections of sterile water into the capsule surrounding the shoulder joint to stretch the capsule tissue and provide room to move the shoulder;
- A procedure in which the patient receives a general anaesthetic and the doctor manipulates the shoulder in different directions to increase tissue suppleness while the patient is “under”;
- Surgery to remove scar tissue from the shoulder joint and increase room to move the shoulder. This surgery will usually be done arthroscopically.
Exercises To Help Recovery From A Frozen Shoulder
To help prevent frozen shoulder problems, or to help the patient recover shoulder range of motion as soon as possible, a physiotherapist can prescribe a program of shoulder exercises to ease the problem. Many of these exercises will involve the use of a shoulder pulley.
