Frozen Shoulder

Frozen shoulder, medically known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint, which gradually leads to a significant loss of range of motion. This condition often develops slowly and can last for months or even years, significantly impacting daily activities and quality of life.

What Causes Frozen Shoulder?

The exact cause of frozen shoulder is not entirely understood, but several factors may contribute to its development:

• Injury or Surgery: A shoulder injury or surgical procedure that limits shoulder movement can trigger frozen shoulder. After an injury, the body may protect the shoulder by restricting movement, leading to stiffness.
• Underlying Medical Conditions: Certain medical conditions, such as diabetes, thyroid disorders, cardiovascular disease, and Parkinson’s disease, are associated with an increased risk of developing frozen shoulder.
• Prolonged Immobilization: Extended periods of immobilization due to injury or surgery can cause the shoulder joint to become stiff and develop adhesions, resulting in frozen shoulder.
• Inflammation: Inflammation of the shoulder joint capsule may play a role in the development of frozen shoulder. This inflammation can lead to the thickening and tightening of the capsule, restricting movement.

Symptoms of Frozen Shoulder

Frozen shoulder typically progresses through three stages, each with distinct symptoms:

• Freezing Stage: This initial stage can last from 6 weeks to 9 months and is characterized by gradually increasing pain and stiffness. Shoulder movement becomes more limited, and daily activities can become challenging.
• Frozen Stage: Lasting from 4 to 12 months, the frozen stage is marked by a significant reduction in shoulder movement. Pain may diminish but stiffness persists, making it difficult to perform tasks that require shoulder mobility.
• Thawing Stage: This final stage can last from 6 months to 2 years and involves a gradual return of shoulder mobility. Pain continues to decrease, and the range of motion improves over time.

Common symptoms include:

• Pain: A deep, aching pain in the shoulder, which may radiate down the arm and worsen with movement.
• Stiffness: A noticeable reduction in the range of motion, making it difficult to reach overhead, behind the back, or across the body.
• Limited Daily Activities: Difficulty performing everyday tasks, such as dressing, reaching for objects, or lifting.

Diagnosing Frozen Shoulder

A healthcare provider will typically diagnose frozen shoulder through a physical examination and a review of the patient’s medical history. During the examination, the provider will assess shoulder mobility and evaluate pain levels. Imaging tests, such as X-rays or MRI, may be ordered to rule out other conditions, such as rotator cuff tears or arthritis.

Treatment Options for Frozen Shoulder

The treatment approach for frozen shoulder focuses on relieving pain, improving mobility, and restoring function. Options may include:

Non-Surgical Treatments

• Physical Therapy: A structured physical therapy program is essential for improving shoulder mobility. A physical therapist will guide patients through stretching and strengthening exercises tailored to their needs.
• Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation associated with frozen shoulder.
• Heat and Cold Therapy: Applying heat to the shoulder can help relax the muscles and improve blood flow, while cold therapy can reduce inflammation and numb pain.
• Corticosteroid Injections: In cases of severe pain, corticosteroid injections may be administered directly into the shoulder joint to reduce inflammation and improve mobility.
• Transcutaneous Electrical Nerve Stimulation (TENS): This therapy uses low-voltage electrical currents to relieve pain and promote relaxation of the shoulder muscles.

Surgical Treatments

If conservative treatments do not provide sufficient relief after several months, surgical options may be considered:

• Manipulation Under Anesthesia: This procedure involves gently moving the shoulder while the patient is under anesthesia to break up adhesions and improve range of motion.
• Arthroscopic Surgery: In this minimally invasive procedure, a surgeon inserts a small camera and instruments into the shoulder joint to remove adhesions and scar tissue, improving mobility.

Recovery and Rehabilitation

Recovery from frozen shoulder varies depending on the individual and the treatment approach. Non-surgical treatments may take several months to show improvement, while surgical recovery can take longer. Engaging in a comprehensive rehabilitation program that includes physical therapy is crucial for restoring shoulder function and preventing recurrence.