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Frozen Shoulder

The medical term for Frozen shoulder is 'Adhesive Capsulitis"


What is frozen shoulder?

Frozen shoulder is a common condition in which the shoulder stiffens with pain, reducing its mobility. Gradual onset of dull aches or pain, usually constant, worse at night, and with cold weather. The condition is thought to be caused by injury or trauma to the area and may have an autoimmune component. Common in people with diabetes. However, the exact cause is not fully understood, and cannot always be identified. The condition is more prevalent in people 40–65 years of age, and in females. The condition develops gradually, tends to be self-limiting and usually resolves over time without surgery. Most people regain about 90% of shoulder motion over time.


Symptoms:

A person with frozen shoulder will have a persistently painful and stiff shoulder joint with progressive loss of both the active and passive range of motion. Signs & symptoms develop gradually, and usually resolve on their own.

The normal cause of a frozen shoulder has been described as having three stages.

  • Stage one: The "freezing" or painful stage: pain increases gradually, making shoulder movements harder & harder, pain maybe worse at night. This stage can last from six weeks to nine months,

  • Stage two: The "frozen" or adhesive stage: is marked by a slow improvement in pain but the stiffness remains. This stage generally lasts from four to six months.

  • Stage three: The "thawing" or recovery stage: shoulder movements get easier and may eventually return to normal. pain fades away, but may occasionally recur. This stage generally lasts six months to two to three years.

  • Over 90% of people with frozen shoulder find that with simple exercises and pain control, symptoms improve. A frozen shoulder normally recovers, but it can take up to 2 years or more.


Source: https://www.coreconcepts.com.sg/condition/frozen-shoulder/




Treatment:

  • Painkillers; Non-steroidal anti-inflammatory drugs [NSAIDs] & Painkillers as per Doctors [GP] advise.

  • Hot or Cold compression packs: Reduces pain & swelling. Alternating between the two may help.

  • Physical therapy: Physical therapy can Provide a tailor-made or customised exercise programme to maintain as much mobility & flexibility as possible without straining the shoulder or causing too much pain.

  • Corticosteroid injections: Steroid injections into the shoulder joint may relieve pain and reduce inflammation. However, repeated corticosteroid injection is discouraged as they can have adverse effects, including further damage to the shoulder.

  • Shoulder manipulation: The shoulder joint is gently moved while the patient is under a general anaesthetic, followed up by a customised exercise programme.

  • Shoulder arthroscopy: A small endoscope, or tube, is inserted through a small incision in to the shoulder joint to remove any scar tissue or adhesions, followed up by a customised exercise programme.

  • The doctor will suggest a suitable option depending on the severity of signs & symptoms.


Exercises:

Frequent, gentle exercises can prevent & possibly reverse stiffness in the shoulder.

  • Crossover arm Stretch: Holding the upper arm of the affected side, gently pull the arm across in front, under the chin. Hold for 10 counts. Relax & repeat.

  • Pendulum stretch: Stand with shoulders relaxed. Lean forward with the hand of the unaffected arm resting on a table. Let the affected arm hang down vertically and swing forward in to the pain and back to your side, circle around 1-foot diameter clockwise, anticlockwise. Increase the diameter over several days, as you gain better range of movement & strength.

  • Towel Stretch: Grab both ends of a towel behind your back. With the good arm, pull the towel and with it, the affected arm, up toward the shoulder. Repeat 10 to 15 times a day.

Exercises should be guided by a doctor, or a physical therapist.


Prevention:

Frozen shoulder can only be prevented if it is caused by an injury that makes shoulder movement difficult. Talk to your doctor or Physical therapist who can advise you on exercises for maintaining mobility & flexibility of the joint.


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