What is Frozen Shoulder?
Frozen shoulder, also called adhesive capsulitis, occurs as a result of stiffness and pain in the shoulder joint that develops gradually over time, worsens, and then resolves. The pain from a frozen shoulder can last up to two to three years.
The terms frozen shoulder and arthritis are frequently used interchangeably. However, these two conditions are entirely distinct and unrelated. Frozen shoulders are most common in people between 40 and 60, affecting women far more than men. It usually affects one or both shoulders of a person. Frozen shoulder is very much common in females with hypothyroidism and associated diabetes the same also holds true with males but to a lesser incidence.
Symptoms Of Frozen Shoulder
Pain and stiffness are common symptoms of frozen shoulders, making movement difficult or impossible.
Frozen Shoulder Stages
A frozen shoulder usually progresses through three stages. Each of these stages has its own set of symptoms and timetable.
1. Freezing stage:
At this stage, an individual experiences pain in their shoulder whenever they move it. These pains can be severe at times and worsen over time. People in this stage frequently report that their pain worsens at night. These symptoms can last anywhere between 2 and 6 months. During this stage, your ability to move your shoulder is restricted.
2. Frozen stage:
The pain in your shoulder subsides, but your stiffness persists and worsens in the frozen stage. Any shoulder movement becomes more complex, making daily activities much more difficult. This stage can last anywhere from 4 to 12 months.
3. The thawing stage:
In this stage, an individual's shoulder range of motion improves with a complete stage to normal or close to normal strength and movement. This stage typically takes six months to 2 years to complete.
Causes
Our shoulder comprises three bones that form a ball and socket joint. They are commonly classified as,
1. The forearm (Humerus)
2. The blade of the shoulder (Scapula)
3. The collarbone (Clavicle)
When a person has a frozen shoulder, the capsules become thick and tight, making it difficult to move the shoulder. However, the causes of frozen shoulders in humans are unknown. A shoulder can become stiff if it is held still for a long period of time, such as after surgery or can be seen very commonly with wrist fractures in old age patients where due to immobilisation, the shoulder goes into a frozen state and is classically called shoulder hand syndrome.
Diagnosis
Typical frozen shoulder diagnosis measures are based on the signs and symptoms that an individual experiences. Further physical examinations are performed, with particular emphasis on the arms and shoulders. A medical professional will perform basic tests such as pressing and moving the arm and shoulder to determine the severity of the problem and to analyse the range of motion in different planes of the shoulder. Typically there is a restriction of movement at the shoulder, and the person cannot take his hand towards his own back.
Imaging tests, such as X-rays or MRIs (Magnetic Resonance Imaging), are frequently used to detect structural abnormalities and the status of the soft tissue envelope around the shoulder joint.
Frozen Shoulder Treatment
The primary goal of treating a frozen shoulder is to increase the range of motion and decrease pain in the shoulder area. A physical therapist is usually recommended to help improve shoulder motion. A therapist will stretch the capsule with the patient's arm and guide them through home exercises that may include a wand or overhead pulley. The therapist will advise you on a stretching routine that you should follow at least once or twice a day. Hot or cold compress packs are sometimes prescribed to relieve pain and swelling.
These exercises use a cane, a home pulley system, and an elastic cord to increase the shoulder's range of motion. Doctors typically prescribe anti-inflammatory medications to alleviate shoulder pain.
If the above-mentioned methods fail to improve the range of motion and reduce pain, an individual may consider surgery. The capsular adhesions are directly cut or released using an arthroscope. Doctors manipulate the shoulder to break down the scarring or toughened soft tissue structures in the operating room. Most patients can begin physical therapy the same day or the next day after surgery.
Frozen Shoulder Exercises
Working with a physical therapist to loosen the stiffness in the shoulder capsule is one of the most common frozen shoulder treatments. Here are three common frozen shoulder exercises you can try to relieve shoulder stiffness.
However, before attempting it on your own, you should consult with your physical therapist.
Stretching with a towel:
Take a towel from the same hand that holds your frozen shoulder. Move your arm in and out toward the centre of your body while holding a towel, and keep your upper body still and your forearm at an angle. Lift your arm gently and bend your forearm as if throwing a ball behind your head. Moving your forearm back and forth in a repetitive motion, as if hammering a nail into a wall, while keeping your upper arm as still as possible. This exercise can also be done with your arm in front of you.
Pendulum exercise:
Dangle your frozen shoulder's arm toward the ground, fingers pointing downward. Then, move your arm in different directions, such as in a circular motion, left and right to the side akin to flapping a wing or back and forth like a swing. This exercise can improve flexibility, increase range of motion, and reduce pain.
Wall climbing:
Wall climbing, also known as finger walking, is an exercise that helps improve flexion and abduction movement and is an easy-to-do home exercise. Hold your arm out in front of you to perform this exercise as if attempting to scale a wall or maybe a mountainside. As if you're trying to grab a ledge, reach higher and higher every few times until your arm is above your head.
Final takeaway
Frozen shoulders can be treated, and the length of recovery varies from person to person.
However, if you suspect you have a frozen shoulder, you must consult with a doctor and a physical therapist as soon as possible.
Backed by a team of multiple sub-speciality orthopaedic specialists and state-of-the-art facilities, and a dedicated physiotherapy department with expert physiotherapists for frozen shoulders, Polaris Hospital has become a centre of choice. Our team of specialists will analyse the root cause and give the appropriate treatment to quickly relieve pain and stiffness and bring back the normal functionality of your shoulder.
About The Author: Dr. Surendra Patil
Dr. Surendra Patil, MBBS, Diploma in Orthopaedics, DNB - Orthopedics Surgery, is a dynamic surgeon with skilled hands well versed in various surgical procedures in orthopedics and exceptionally well-read in his chosen expertise. He is proficient in Arthroscopic Surgeries, Adult Joint Reconstruction Surgery, Accidents & Emergencies, Joint Replacement, Healthcare Management, and Healthcare in general. He is an experienced Medical Professional with a demonstrated history of working in the hospital & healthcare industry.
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