Frozen Shoulder

Frozen Shoulder

Frozen shoulder, or adhesive capsulitis, is a condition that limits the range of motion of the shoulder. It causes a considerable amount of pain in the shoulder, which progressively increases over time.

The condition takes about 1 to 3 years to completely resolve.

What is Frozen Shoulder?

There are three bones in the shoulder, namely the humerus (upper arm), scapula (shoulder blade), and clavicle (collarbone). These bones, along with the ligaments and tendons that make up the shoulder joint, are encased in a capsule of connective tissue. In a frozen shoulder, this capsule becomes hard and thick, making movement difficult. The synovial fluid that lubricates this joint becomes less abundant. The development of bands of scar tissue also aggravates this condition.

What are the causes of Frozen Shoulder?

There is no clear evidence to prove who is more prone to getting this condition. However, there are certain risk factors associated with this condition:

• Sex: Women are more likely to suffer from this than men.
• Age: It is usually seen among the age group of 40 to 60 years.
• Health issues: About 10% to 20% of people who are diabetic also suffer from frozen shoulders. People who are recovering from a medical condition like a stroke or who have had surgery like a mastectomy, which restricts arm movement, are more likely to develop frozen shoulders. Certain other medical conditions, like thyroid disease, heart disease, or Parkinson’s disease, can greatly increase your chances of developing a frozen shoulder.

What are the symptoms of frozen shoulder?

This condition is marked by pain and stiffness of the shoulder joint, making movement very hard. The pain may be located on one shoulder or in the shoulder muscles of the upper arm. The pain may aggravate at night, making it very difficult to sleep.

The frozen shoulder progresses in three phases. Each phase is marked by its own unique symptoms.

• Freezing Stage
  • Development of severe pain in the shoulder on movement
  • Worsening of the pain, especially at nights
  • Limited movement of the shoulder for anywhere between 6 to 9 months
• Frozen Stage
  • Relief in pain but gradual worsening in stiffness
  • Marked effort in moving the shoulder, limiting daily activities
  • The duration of this stage is 4-12 months.
• Thawing Stage
  • Movement starts getting back to normal
  • The duration of this stage ranges from 6 months to 2 years.

What are the ways to diagnse frozen shoulder?

The diagnosis of a frozen shoulder requires a thorough physical examination and few diagnostic tests.

• Physical examination: Your doctor would check the range of motion of your shoulder joint and how badly it hurts during these movements. The doctor would ask you to move your shoulder on your own (active movements) and follow it up by moving the shoulder for you (passive movements). This may require injecting an anesthetic into your shoulder so that movement can be made possible.
• Diagnostic tests: Although a physical examination is generally enough to diagnose a frozen shoulder, your doctor may call for some diagnostic tests. An X-ray, MRI, or ultrasound may be performed to see if the pain and stiffness are due to problems like arthritis or a torn rotator cuff.

What are treatment options for frozen shoulder?

Non-steroidal anti-inflammatory drugs (NSAIDs) that are easily available over the counter may be prescribed by the doctor to relieve pain. Apart from medications, your doctor would ask you to perform stretching and strengthening exercises to improve your range of motion. Other treatment options may be looked into if the condition persists. These are given below:

• Physical therapy: This is more advantageous during certain phases of the frozen shoulder. It includes exercises to increase the range of motion of the shoulder joint.
• Joint distension: The shoulder capsule is stretched by means of injecting sterile water. The shoulder can be easily moved by doing so.
• Injection: Corticosteroid injections may be administered in the shoulder joint to lessen the pain and increase its mobility.
• Surgery: An operation is less likely to be performed in order to treat a frozen shoulder. It is only done if other measures haven't helped. The surgery involves an arthroscopic procedure, where light-weight and pencil-sized tools are inserted via small cuts in the shoulder.
• Shoulder manipulation: Under general anesthesia, the doctor the forcefully moves the shoulder. This helps to loosen the shoulder tissue. This method is not very popular as it can lead to complications like fractures. It is now replaced by the modern arthroscopic surgery.