Medical Centric

FROZEN SHOULDER

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FROZEN SHOULDER

Frozen shoulder is a condition characterized by inflammation, stiffness and chronic pain in the shoulder joint.

  • The shoulder is made up of three bones that form a ball-and-socket joint – the upper arm (humerus), shoulder blade (scapula), and the collarbone (clavicle)
  • There is also tissue surrounding the shoulder joint that holds everything together. This is called the shoulder joint capsule
  • With this condition, the shoulder joint capsule becomes inflamed, scarred, thickened and so tight that it greatly restricts motion and causes chronic pain.
  • Medically, a frozen shoulder is referred to as adhesive capsulitis
  • Frozen shoulder can result in depression, problems in the neck and back, and severe weight-loss due to long term lack of deep sleep.
  • Frozen shoulder is more prevalent in women and it majorly occurs in people between the ages of 40 and 65.

CAUSES

Doctors are not sure why frozen shoulder happens to some people, although it is more likely to occur in some group of people, such as people who have diabetes or those who recently had to immobilize their shoulder for a long time, such as after an arm fracture or a surgery.

Certain factors that may increase the risk of getting the condition include:

  • Age
  • Immobility or reduced immobility which may result from a broken arm, stroke, recovery from surgery, or rotator cuff injury
  • Diseases including tuberculosis, cardiovascular disease, hyperthyroidism, hypothyroidism, Parkinson’s disease.

SYMPTOMS

Symptoms are in three stages.

The freezing stage where the shoulder becomes stiff and any movement of the shoulder causes pain. Range of motion starts to become limited. Pain may get worse at night, resulting in reduced sleep.

The frozen stage where pain may begin to diminish, but the shoulder remains stiff. This makes it more difficult to carry out daily tasks and activities.

The thawing stage where pain lessens and the range of motion in the shoulder begins to improve. This is also called the recovery stage and may last for 6 months to 2 years.

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will ask you to move in certain ways to check for pain and evaluate your range of motion. This type of examination, in which you are moving your arm and not the doctor is called an active range of motion

The doctor will also move your shoulder to check your range of motion and pain that accompanies the movement. This type of examination, where the doctor is moving your arm is called a passive range of motion.

The two types of motion are compared. Frozen shoulder affects both active and passive range of motion.

Imaging tests such as an X-ray of the shoulder may be ordered to rule out other conditions, such as arthritis.

TREATMENT

Treatment options may include:

Over-the-counter or prescribed pain relievers.

Therapy where you learn exercises to help you recover as much mobility in your shoulder as possible.

Surgical and other procedures for persistent symptoms. The doctor may suggest:

  • Steroid injection
  • Shoulder manipulation
  • Joint distension
  • Surgery to remove scar tissues and adhesion from the shoulder joint. Surgery is usually rare