Adhesive Capsulitis or frozen shoulder affects the shoulder joint in people over forty. This joint condition can not only limit the mobility of the shoulder joint but also cause considerable pain.
What is a Frozen Shoulder?
The shoulder is a ball-and-socket joint encased in a capsule of connective tissue. When the shoulder capsule thickens and tightens, preventing the shoulder from moving usually, this condition is known as a frozen shoulder.
Adhesive Capsulitis, another name for frozen shoulder, causes discomfort or stiffness in one or both shoulder joints and a lack of mobility. The discomfort and lack of mobility might interfere with daily activities.
What Causes a Frozen Shoulder?
Sometimes a frozen shoulder begins to develop without any identifiable cause. Other times, an injury, repetitive stress, or unstable shoulders could be to blame. Diabetes increases a person’s risk of developing a frozen shoulder.
Frozen shoulder happens due to inflammation (swelling, discomfort, and irritation) of the tissues around the joint, even though numerous shoulder disorders can induce pain and mobility loss.
The capsule is the tissue that surrounds the joint and holds it together. The capsule often includes folds that may enlarge and decrease when the arm assumes various postures. The capsule is inflamed and scarring forms in a frozen shoulder.
Adhesions are the name for the scarring structures. Movement of the shoulder is limited and painful as the capsule’s folds become scarred and constricted. Adhesive Capsulitis (scarring) is the name of this condition (capsule inflammation).
What precisely causes this disease is unclear. A frozen shoulder can develop if the shoulder is immobile (following an arm injury, for example). The shoulder joint may also become frozen due to inflammation of the muscles and/or tendons, such as in rotator cuff tendinitis or bursitis.
How Do I Know if I Have a Frozen Shoulder?
At night, the symptoms and signs become more noticeable. The main symptom, which gradually gets worse over time and gets worse at night, is shoulder pain. The joint shoulder movement makes the pain worse. Inflammation is the direct cause of this pain.
The “freezing” stage is characterised by intense pain and a considerable restriction in the shoulder joint’s range of motion. This limitation could be so strict as to restrict daily activities like getting dressed.
Most of the time, it takes about 18 months for the symptoms of a frozen shoulder to start going away on their own. This is the ‘thawing’ stage.
How is a Frozen Shoulder Diagnosed?
Your doctor will physically examine you to identify a frozen shoulder. Then, they will examine it to see how painful and far it travels. The “active” part of the exam will allow you to move your shoulder independently. Then, they will move it for you and note the variations during the “passive” part.
Your doctor could determine that you require an anaesthetic injection in your shoulder. This drug will dull the pain so they can more accurately assess your active and passive range of motion.
A physical examination often diagnoses a frozen shoulder. Still, your doctor may also request imaging tests like X-rays, ultrasounds, or MRIs to rule out other conditions like arthritis or a torn rotator cuff that can hurt and restrict how far it can move.
Management for Frozen Shoulder Movement
Treatment aims to reduce inflammation and pain. Medication is used to achieve this. Additionally, therapeutic exercises are started to help the shoulder joint regain mobility and functionality. Minimally invasive surgery can be considered if the symptoms do not disappear in 18 months.
How is Frozen Shoulder Treated?
The two primary treatment goals are to improve the shoulder’s ability to move and reduce frozen shoulder pain. In addition, physical therapy is typically recommended to improve mobility and prevent a frozen shoulder from worsening.
Most patients are given at-home exercises that can involve using a wand or overhead pulley by the physical therapist, who also rotates the patient’s arm to stretch the capsule. Additionally, they could apply heat, cold, ultrasound, or electrical stimulation.
The therapist will demonstrate a stretching routine that you should practise at least once or twice daily. These workouts use a cane, a home pulley system, and an elastic string to increase shoulder mobility.
Anti-inflammatory medications like aspirin, ibuprofen (Motrin, Advil), Naprosyn, or Aleve are frequently advised by doctors to treat pain. In addition, narcotics or painkillers like Tylenol may be prescribed to help sleep at night or lessen pain after therapy.
Steroid injections into the joint or bursa may sometimes be necessary. In addition, prednisone and other oral steroids could be administered to help reduce inflammation and improve shoulder motion.
What are the Symptoms of a Frozen Shoulder?
A dull pain in your shoulder and the shoulder muscles surrounding the top of your arm is the most noticeable symptom of a frozen shoulder. You may find it challenging to fall asleep at night because the pain may get worse.
You might be unable to move as freely because of how tight the shoulder capsule is. A frozen shoulder heals in 3 distinct stages over the course of 2 to 3 years. So every step could go on for several months.
Freezing Stage
- A pain (sometimes very intense) develops every time you move your shoulder.
- Over time, it gradually gets worse and might hurt more at night.
- This may last for six to nine months.
- Your shoulder’s range of motion is constrained.
Frozen Stage
- Although your pain could reduce, your stiffness will only get worse.
- It becomes more challenging to move your shoulder and more difficult to carry out daily tasks.
- 4 to 12 months are possible for this stage.
Thawing Stage
- You begin to regain your normal range of motion.
- It could take anywhere from six months to two years to complete
What are the Risk Factors for a Frozen Shoulder?
You have a higher risk of developing a frozen shoulder if
You are:
- more than 40 years old
- Females as they are more likely to get a frozen shoulder as compared to men
You have a history of –
- Stroke
- Parkinson’s condition
- A cardiovascular condition
- Endocrine conditions like diabetes and thyroid issues,
- prolonged periods of inactivity or restricted motion brought on by pain, or the healing process after an operation or injury
- Injury or trauma, like a fracture.
What are the Complications and Related Diseases of a Frozen Shoulder?
Frozen shoulder complications include:
Stiffness & Pain – After non-surgical treatment, some people may still feel stiff or pain for up to 3 years.
Bone Or Tissue Damage – The humerus, or upper arm bone, may, every once in a while, be damaged during shoulder manipulation, along with the biceps and subscapularis tendons.
Recurrence Of Frozen Shoulder – Although uncommon, frozen shoulder can recur. This is more typical if diabetes or another chronic condition is the cause of the frozen shoulder.
FAQ About Frozen Shoulder Movement
Shoulder support is the most common treatment for most patients with frozen shoulders. While support will reduce the pressure and wear and tear on the area, painkillers only temporarily relieve pain. Physiotherapy and exercises such as stretching can also be suggested to strengthen the shoulder and reduce the pain.
A frozen shoulder could take 2-20 months to heal completely. The recovery may not be complete in some severe cases. In such circumstances, you might still experience mobility issues when performing household tasks and experience sporadic bursts of pain.
The procedure is carried out using a keyhole surgical technique (arthroscopy). Through a small incision, the surgeon inserts a camera into your shoulder to view the images on a screen. A second incision is used to release the inflamed capsule.
As part of the procedure, a steroid injection may be given into the joint, and the wound may be stitched closed. Surgery can help you deal with a frozen shoulder and related shoulder pain.
The condition will probably worsen if untreated, leading to pain, stiffness, and a restricted range of motion. The longer it goes untreated, the harder it can be to treat it both surgically and non-surgically. Therefore, it is essential to seek treatment from an orthopaedic specialist if you think you might have a frozen shoulder.
