Frozen shoulder, also called adhesive capsulitis, is a condition characterized by pain and stiffness in the shoulder joint. Symptoms typically start steadily, worsen over time, and then resolve slowly within 1 to 3 years. Physical therapy is the primary treatment advised for frozen shoulder. It mostly affects people between 40 and 60 years old and is more common in women than in men. Also, people with diabetes have a higher risk of developing a frozen shoulder.
What are the symptoms?
Severe pain, along with the inability to move the shoulder/ arm, are hallmark symptoms of the frozen shoulder.
It progresses slowly and includes 3 stages:
- Freezing stage:
- Range of motion reduces, and movement of the shoulder causes pain. This stage typically lasts for 6 weeks to 9 months.
- Frozen stage:
- Pain may reduce in this stage, but the shoulder joint becomes stiffer, and movement becomes more difficult.
- Thawing stage:
- The range of motion slowly begins to improve. Complete return to normal strength and movement may take 6 months to 2 years.
In some cases, the pain may worsen at night and disrupt the sleep.
What are the causes of frozen shoulder?
The shoulder joint is made up of ligaments, tendons, and bones which are encased in a capsule of connective tissue. When this capsule thickens, it restricts the movement of the joint and leads to Frozen shoulder. Thick bands of tissue called adhesions develop inside the joint.
The exact cause of Frozen shoulder is still not known, but it is more likely to occur in those people whose shoulder was immobilized for a long period due to surgery or fracture.
What are the risk factors?
Certain factors may increase this risk of frozen shoulder like:
Age and gender: People above 40 and particularly women have a higher risk
Immobility: People who had reduced mobility or prolonged immobility due to:
Diseases: Diseases that might increase the risk are:
- Diabetes
- Thyroid issues
- Tuberculosis
- Cardiovascular disease
- Parkinson’s disease
What is the treatment for Frozen shoulder?
Medications: over-the-counter pain-relieving drugs like ibuprofen (Advil, Motrin) may help reduce the pain. If you don’t get much relief from them, your doctor may prescribe stronger pain-relieving drugs.
Therapy: Physical therapy plays a significant role in treating Frozen shoulder. The physical therapist teaches exercises to improve as much movement in your shoulder as possible. It includes stretching or range of motion exercises for the shoulder joint. These exercises should be done persistently to get the maximum benefit.
Other procedures:
Most people get better with medicines and therapy within 12 to 18 months. For others, the doctor may suggest:
Shoulder manipulation: The patient is anesthetized, and the doctor moves the shoulder joint in different directions to loosen the tightened capsule. This reduces the stiffness and improves the range of motion.
Surgery: If you don’t get relief from any of the above methods, your doctor may recommend surgery. It is done to remove the scar tissue and adhesions from the joint. This surgery is usually performed with an arthroscope, which is a tubular device with light and camera. Pencil-sized instruments are inserted through small incisions on the shoulder.
In many cases, both arthroscopy and manipulation are used to get the best results.
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