Frozen Shoulder: Frozen shoulder a commonly used term describes ‘Adhesive Capsulitis’, an incapacitating and sometimes astringent painful condition of the shoulder. It is a disorder where the shoulder capsule and connective tissue circumventing the shoulder joint becomes stiff and thickened greatly restricting kineticism and causing chronic pain. It is consequential to have an opportune diagnosis to guide optimal management of the condition.
Frozen Shoulder(Adhesive Capsulitis) Symptoms
Sedulous stiffness and pain in the shoulder joint are the two main symptoms of a frozen shoulder. Arduous to perform everyday tasks, such as-
- Sleeping comfortably
Causes of Frozen Shoulder
It is unknown what causes a frozen shoulder. Infrequently it can commence after shoulder injury but it frequently commences with no categorical preceding incident. It can last from 6 months to up to 3 years.
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Risk Of Developing a Frozen Shoulder
Frozen shoulder affects 5% of people over their lifetime. People in their 40s and 70s are most liable to develop the quandary. It is very recherche in those under 40 years of age. It inclines to be more prevalent in females than males (incidence of females: males 6:4).
Developing frozen shoulder is withal incremented in those who withal suffer from other health quandaries such as diabetes, stroke, lung disease, connective tissue disorders and heart disease.
Diagnosis of Frozen Shoulder
The three main hallmarks of frozen shoulder are shoulder stiffness that comes on for no categorical reason; rigorous pain that becomes worse at night and in algid weather; and near consummate loss of passive & active external rotation of the shoulder.
Shoulder pain is associated with conditions such as – shoulder impingement, bursitis, rotator cuff tear, calcific tendonitis, referred pain from the neck and nerve pain. These quandaries may additionally cause reduced kineticism but they will not cause the kineticism loss in all directions or the pattern of pain typical of frozen shoulder.
A frozen shoulder can usually be diagnosed on examination by your doctor or physiotherapist, with no special tests needed. An x-ray may be obtained to ensure the shoulder joint looks normal and there is no evidence of arthritic changes or injury to the joint. An MRI may be performed if the diagnosis is unsure, but it is used to rule out other problems rather than investigate frozen shoulder.
Stages of Frozen Shoulder
Freezing Stage– The shoulder gradually becomes painful and loses movement over six weeks to nine months. Shoulder outward motion is usually lost first, followed by other directions of movement. This is the most painful stage. Overzealous stretching and activity are NOT recommended at this stage as it is likely to worsen the symptoms.
Frozen Stage- In this stage, restriction of range and stiffness is the main concern. Conventionally pain has settled. This stage may last from 4 to 9 months. Therapy during this stage has not shown to provide many benefits.
Thawing Stage- Treatment is most propitious at the thawing stage and should aim at maximizing the range of kineticism and gradually building strength. Shoulder kineticism should gradually return to mundane but for some people, kineticism may remain mildly restricted. This stage can last five months to 26 months.
Treatment for Frozen Shoulder
Treatment for frozen shoulder customarily consists of pain mitigation and physical therapies to improve kineticism and muscle function.
Over-the-counter pain relievers, such as aspirin and ibuprofen can avail reduce pain and inflammation associated with frozen shoulder. In some cases, your medico may prescribe more vigorous pain-mitigating and anti-inflammatory drugs.
When analgesics aren’t availing to control the pain, it may be possible to have a corticosteroid injection in your shoulder joint.
Corticosteroid injections may damage your shoulder, and the injections often become less efficacious over time, so your medico may recommend having no more than three injections.
Stretching exercises are a mainstay of treatment for ‘frozen shoulder’ and need to be performed up to three times a day. The kind of stretches will differ depending on the stage of your quandary and your needs, so it is consequential that your program is developed under the guidance of your physiotherapist.
Strengthening exercises avail reduce the loss of muscle strength and muscle mass due to disuse of the shoulder and scapular muscles. For functional shoulder, activity is additionally consequential to maintain proper postural muscle control and endurance.
Heat and TENS can be used frequently for pain palliation. Heat avails to loosen the shoulder joint and capsule. TENS (transcutaneous electrical nerve stimulation) is a form of electrotherapy that is designed to provide pain palliation. Once prescribed by your physiotherapist TENS can be applied as a home treatment. Ultrasound has been found to provide some benefit in the ‘freezing stage’ for pain palliation and mobility.
Mobilizations are physical techniques performed by your physiotherapist, to locally stretch and lengthen the shoulder capsule and provide pain relief.
Acupuncture can be helpful with other treatments for frozen shoulder. It can reduce pain in the ‘freezing stage’ and increase mobility during the ‘thawing stage’.
It is consequential to see your medico or physiotherapist if you have the painful or restricted shoulder. Appropriate diagnosis is consequential for proper shoulder treatment. Once identified as a frozen shoulder, an individualized exercise program and pain relief modalities are consequential for management. Treatment during the ‘thawing stage’ will distribute best results.