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What is a Frozen shoulder?
Frozen Shoulder also known as adhesive capsulitis or Periarthritis is a condition characterised by pain & stiffness of the shoulder joint. To break the myth, a frozen shoulder is the development of capsular restrictions, rather than arthritic changes in the bone or cartilage that occur with Osteoarthritis or Rheumatoid arthritis. The capsule thickens and tightens with a frozen shoulder, making it difficult to move. Scar tissue develops in the joint, and synovial fluid which keeps the joint lubricated, is reduced. These things make it much more difficult to move.
There is no known cause of a frozen shoulder, hence it is called idiopathic. Although disorders in which there is prolonged pain & restricted motion such as trauma, immobilisation, RA or OA may lead to a secondary frozen shoulder. The pathogenesis for a primary frozen shoulder can be a chronic musculotendinous or synovial tissue inflammation, such as the biceps tendon, rotator cuff or joint capsule. People with Diabetes mellitus are at a higher risk of developing this disorder. The onset of a frozen shoulder is gradual & it generally occurs between the ages of 40 & 65 years.
Stages of Frozen Shoulder
This clinical disorder progresses in a series of four stages. Each stage follows a continuum & can last several months.
Stage 1
The duration of this stage is less than 3 months. The onset is gradual & the pain increases with movement and at night time.
Stage 2
Referred to as the "Freezing Stage". The duration of this stage is between 3 and 9 months after onset. The pain is more intense at rest. The shoulder range of motion gets limited in all directions. phy
Stage 3
Referred to as " Frozen Stage".The duration of this stage is between 9 & 15 months after onset. The pain occurs with movement. However, pain starts to diminish in this stage. The shoulder becomes stiffer & movement becomes difficult.
Stage 4
Referred to as the " Thawing Stage".The duration of this stage is between 15 to 24 months after onset. The pain is minimal and the shoulder motions gradually improve during this stage.
Common Impairments of Functions & Structures in Frozen Shoulder
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Night pain & disturbed sleep.
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Pain on motion & at rest.
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Reduced mobility: Inability to reach overhead, behind the back, difficulties in dressing( wearing a shirt), reaching hands in the pant's back pockets, self-grooming(combing hair, brushing teeth), etc.
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Difficulties lifting objects beyond shoulder level.
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Posture: Faulty posture compensations( Protracted shoulders, or guarding the painful shoulder in elevation & adduction.)
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Glenohumeral muscle weakness.
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Limitations to sustain repetitive movements.
Frozen shoulder treatment
The treatment may include NSAIDs that help relieve pain & inflammation. The treatment also includes physiotherapy (Strengthening & stretching exercises) to improve the range of motion of the shoulder joint. Manipal Hospitals Kharadi has some of the best physiotherapists in Pune to help you with exercise and care. If the symptoms do not improve with time, the following treatments can be recommended.
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A Corticosteroid injection: is given to reduce pain & improve ROM
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Joint Dissection: Sterile water is injected into the shoulder capsule to stretch which helps to move the shoulder easily.
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Physiotherapy: Stretching and strengthening shoulder girdle muscles to improve range of motion & pain reduction.
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Shoulder manipulation: It is rarely done as shoulder arthroscopy has taken over. It is performed under General Anesthesia, and the surgeon may manipulate the joint.
Frozen shoulder Prevention
Immobility that occurs as a result of a shoulder injury, a broken arm, or a stroke is one of the most prevalent causes of a frozen shoulder. If you have suffered an injury to your shoulder that makes it difficult to move it, talk to your doctor about exercises you may have to follow to keep your shoulder range of motion. Getting a proper diagnosis is the first step towards treatment. Manipal Hospitals Kharadi has the top physiotherapist in Pune for all your bone health concerns and treatment. Book an appointment or visit your nearest Manipal Hospitals in Kharadi, Pune to experience the best of healthcare.
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