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Frozen Shoulder

 Frozen Shoulder or Adhesive Capsulitis is a condition that affects the Shoulder Joint. The Shoulder is made up three bones – Shoulder blade (scapula), the collarbone and the upper arm bone (humerus). The shoulder is a ball and socket joint where the round head of the humerus fits into the socket. Connective tissue known as the capsule surrounds the shoulder joint and synovial fluid lubricates the shoulder capsule and joint so that it moves freely. In Frozen Shoulder, shoulder capsules become thicker and tighter and over time scar tissues are developed. Also, in many cases there is not enough synovial fluid to lubricate the shoulder. This limits the motion of the shoulder and in extreme cases the shoulder gets locked – hence called Frozen Shoulder

Frozen Shoulder

Man with Frozen Shoulder (Adhesive Capsulitis)

Causes and risk factors of Frozen Shoulder

Exact causes of Frozen Shoulder are not known. However, there are certain risk factors that enhances the chances of getting Frozen Shoulder

Age: Frozen Shoulder generally affects people between the age of 40 and 50

Gender: It is more common in women than in men

Diabetes: 10 to 20% of people with diabetes develop frozen shoulder

Recent Trauma: Injury, illness or surgery also makes you more vulnerable to develop frozen shoulder

Other conditions that increases the risk are:

    • Hyper and Hypothyroidism
    • Cardiovascular disease
    • Parkinson’s disease
    • Stroke
    • Tuberculosis
    • Breast Cancer
    • Open Heart Surgery
    • Depression Frozen Shoulder can sometimes develop alongwith other Shoulder conditions like Calcific Shoulder Tendonitis and Rotator Cuff Tear.

Symptoms of a Stiff Shoulder

The most prominent symptom is shoulder pain and limited range of motion in the shoulder. In mild cases, there will be pain however other functions of the shoulder remain unaffected. In severe cases, the mobility of the shoulder is very limited thus affecting the everyday tasks like bathing, dressing, driving etc. There will be trouble sleeping on the affected side. There are three stages of frozen shoulder:

Stage 1 (Freezing Stage) – In this stage, pain will be predominant with limited motion of the shoulder. Pain worsens at night making it difficult to sleep. This stage normally lasts for 6 weeks to 9 months.

Stage 2 (Frozen Stage) – In this stage, the pain may be reduced however the shoulder joint becomes more stiff. Performing day to day activities like bathing, dressing, driving etc becomes difficult. This stage lasts for 4 to 6 months

Stage 3 ( Thawing Stage) – This is the final stage where the motion of the arm gradually improves. Pain and stiffness starts to reduce. This stage can last from 6 months to couple of years.

Diagnosis of Adhesive Capsulitis

Your Shoulder Specialist will perform one or more of the following tests to diagnose Frozen Shoulder and determine its stage:

    • Physical Examination
    • X-Rays
    • Ärthrogram
    • Magnetic Resonance Imaging (MRI)

Treatment of Frozen Shoulder Syndrome

In many cases, Frozen Shoulder improves over time with or without treatment. However, treatment can help manage the pain better, relieve other symptoms and speed up the healing process.

Non-Steroidal Anti Inflammatory Drugs(NSAIDs)
In mild cases, non-steroidal drugs are prescribed to reduce the pain and swelling.

Physical Therapy
A customized physio therapy program will be charted out depending on your condition. Regular physical therapy has helped most of the patients gain the arm motion and recover from Frozen Shoulder.

Steroid Injections
In severe cases, where non-steroid medications do not help relieve the pain and the patient is unable to perform physiotherapy – Steroid injections are given to reduce pain and inflammation.

Frozen Shoulder

X-Ray of Scar Tissues of Frozen Shoulder

Surgery and Procedures

Shoulder Arthroscopy

If all the non-surgical conservative treatment fails to relieve the pain and symptoms, your Shoulder Doctor will recommend Shoulder Arthroscopy in selected cases. This procedure is designed to increase the range of motion and improve shoulder movement.

Manipulation under anesthesia

In this procedure, doctor provides the patient with anesthesia and then force the shoulder to move in several directions. This cuts and tears the scar tissues thus enabling increased motion of the shoulder.

Recovery and Rehabilitation after a Shoulder Therapy/Surgery

A physical therapy is necessary after surgery. Commitment to regular physical therapy has helped most of the patients recover completely from Frozen Shoulder and its symptoms.

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