What is a frozen shoulder?

 

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness, pain, and limited range of motion in the shoulder joint. It occurs when the capsule surrounding the shoulder joint thickens and tightens, leading to reduced synovial fluid production and increased adhesions within the joint. This results in difficulty moving the shoulder in various directions, causing pain and discomfort. A frozen shoulder typically develops gradually over time and may worsen without proper treatment. It can be caused by factors such as injury, immobilization of the shoulder, certain medical conditions (e.g., diabetes, thyroid disorders), or unknown reasons (idiopathic). Treatment for frozen shoulder may include physical therapy, pain management, anti-inflammatory medications, corticosteroid injections, and in some cases, surgery to release the tight capsule.

 

What are the causes of frozen shoulder?

 

The causes of frozen shoulder, also known as adhesive capsulitis, are not fully understood, but several factors may contribute to its development:

● Diabetes: People with diabetes are at a higher risk of developing frozen shoulder. The reason for this association is not completely clear, but it is believed that diabetes may lead to changes in the shoulder joint tissues, making them more susceptible to stiffness and adhesions.

● Other Medical Conditions: Certain medical conditions like hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease have been linked to an increased risk of frozen shoulder. These conditions may affect joint health and contribute to the development of adhesive capsulitis.

● Immobilization: Frozen shoulder can occur after a shoulder has been immobilized for a period of time due to injury, surgery, or other reasons. Lack of movement in the shoulder joint can lead to the formation of adhesions and stiffness, contributing to the development of frozen shoulder.

● Injury or Surgery: Trauma to the shoulder, such as a fracture or dislocation, or surgery involving the shoulder joint can trigger inflammation and scar tissue formation, leading to stiffness and restricted movement characteristic of frozen shoulder.

● Unknown Factors (Idiopathic): In some cases, the exact cause of frozen shoulder is unknown. It may develop spontaneously without any apparent trigger or underlying medical condition.
 

Overall, frozen shoulder is likely to result from a combination of factors, including underlying medical conditions, immobility, and inflammation, although the precise mechanisms are not fully understood.
 

What are the symptoms of frozen shoulder?

 

The symptoms of frozen shoulder, also known as adhesive capsulitis, typically progress gradually and can vary in severity. Common symptoms include:

● Pain: Persistent dull or aching pain in the shoulder joint, which may worsen with movement or at night, especially during the early stages of the condition.

● Stiffness: Progressive stiffness in the shoulder joint, making it difficult to move the arm in various directions, such as reaching overhead, behind the back, or out to the side. The stiffness may worsen over time and severely limit shoulder mobility.

● Limited Range of Motion: Decreased range of motion in the shoulder joint, both actively (when the individual tries to move the shoulder) and passively (when someone else moves the shoulder). This limitation in movement is a hallmark feature of frozen shoulder.

● Painful Movement: Pain or discomfort with certain movements of the shoulder, particularly when attempting to reach or lift objects, rotate the arm, or perform overhead activities.

● Difficulty with Daily Activities: Difficulty performing daily tasks that require shoulder movement, such as dressing, combing hair, reaching into cupboards, or driving.

● Progression through Stages: Frozen shoulder typically progresses through three stages: freezing stage (increased pain and stiffness), frozen stage (persistent stiffness with some improvement in pain), and thawing stage (gradual improvement in range of motion and pain relief).

● Symptoms in Both Shoulders: In some cases, frozen shoulder may affect both shoulders, although it often develops in one shoulder at a time.
 

How is frozen shoulder treated?

It's important to note that the symptoms of frozen shoulder can vary from person to person, and the condition may progress differently in each individual. If you experience persistent shoulder pain, stiffness, or limited mobility, it's advisable to seek medical evaluation for proper diagnosis
and treatment.
 

Frozen shoulder is typically managed with a combination of conservative treatments aimed at reducing pain and stiffness, restoring shoulder mobility, and promoting healing. Treatment options may include:

● Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help alleviate pain and reduce inflammation associated with frozen shoulder.

● Physical Therapy: Physical therapy is a cornerstone of treatment for frozen shoulder. A physical therapist can design a personalized exercise program to improve shoulder mobility, flexibility, and strength. This may include stretching exercises, range of motion exercises, and strengthening exercises for the shoulder muscles.

● Steroid Injections: Corticosteroid injections directly into the shoulder joint can help reduce inflammation and alleviate pain associated with frozen shoulder. These injections are typically administered by a healthcare professional and may provide temporary relief.

● Manipulation Under Anesthesia (MUA): MUA is a procedure in which the shoulder joint is manipulated while the patient is under anesthesia to break up adhesions and scar tissue, allowing for improved range of motion. It is usually followed by physical therapy to maintain the gains achieved during the procedure.

● Shoulder Arthroscopy: In cases where conservative treatments fail to provide relief, shoulder arthroscopy may be considered. This minimally invasive surgical procedure involves inserting a small camera (arthroscope) and surgical instruments through small incisions in the shoulder to remove adhesions and release tight structures in the joint capsule.

● Home Care: In addition to professional treatments, home care measures such as applying ice packs to the shoulder, using heat therapy, and gentle stretching exercises prescribed by a healthcare provider may help alleviate symptoms and improve mobility.

The choice of treatment depends on the severity of symptoms, stage of frozen shoulder, and individual patient factors. It's important for individuals with frozen shoulder to work closely with their healthcare providers to develop a comprehensive treatment plan tailored to their specific needs and goals.