What is a Frozen Shoulder?

frozen shoulder
It’s understandable if the thought of a frozen shoulder sends a chill down your spine, because it is a condition that equates to loss of mobility, something no one wants to experience. Frozen shoulder, also known as adhesive capsulitis, is a condition resulting when there is injury and inflammation in the soft tissues surrounding the shoulder.

The shoulder is a ball and socket joint, and the head of the upper arm bone, the humerus, fits into a cavity created by the shoulder bone, the scapula. The inflammation in this capsule makes movement more difficult and painful. The joint may also lose some of the synovial fluid that lubricates it.

However, reduced movement causes capsule to thicken and contract, leaving less room for the shoulder joint to move around, so it is actually a vicious cycle: the shoulder is painful, so you move it less often, but the less you move it, the more likely the capsule is to contract. In advanced cases, scar tissue can form between the upper arm bone and the capsule.

What is the main cause of Frozen Shoulder?

Frozen shoulder often occurs when a person doesn’t undergo therapy after an injury or a bout of tendinitis. It can also happen following a period of enforced immobility, such as being bedridden after a stroke or heart attack, or occur following a fall or an automobile accident.

Adults over 40 are most susceptible to frozen shoulder, and more women experience it than men. Diabetics are also susceptible. The condition may appear without any obvious injury or inflammation.

Frozen Shoulder Stages: A Three-Stage Concern

The development and healing of frozen shoulder is generally divided into three stages: the freezing stage, the frozen stage and the thawing/healing stage.

During the freezing stage, the inflammation has occurred. The shoulder stiffens and hurts and movement becomes challenging. The pain is generally worse at night. There are five symptoms generally associated with inflammation: pain, swelling, heat, redness and loss of function.

Once the shoulder is frozen, the inflammation begins to subside, because the shoulder capsule has thickened and reduced range of motion.

“Thawing” a frozen shoulder refers to eradicating the conditions that caused it, allowing for movement and disappearance of pain. Once inflammation has subsided, it is possible to move the shoulder more; this action allows for the lubricating synovial fluid to being flowing again and work its way into the shoulder capsule. As the shoulder moves more, scar tissue begins to break up and becomes reabsorbed by the body.

Frozen Shoulder Diagnosis

After discussing the symptoms with you, your physician will test your range of motion to see where the limitations in movement occur and assess the pain you are feeling. Frozen shoulder doesn’t allow for a great range of motion, either passively – when someone else moves your shoulder – or actively – when you move your own shoulder.

frozen shoulder exercises

X-rays or magnetic resonance images (MRIs) may be used to rule out other potential causes of your pain and restricted movement, such as arthritis or a torn rotator cuff.

What is the best treatment for a Frozen Shoulder?

Frozen shoulder doesn’t heal overnight, so patience is required; full recovery can take up to three years. Many patients respond to simple treatments to control pain and restore motion. The goal of treatment is to alleviate pain and restore motion with the help of physical therapy.

Initially, assistance comes in the form of pain management. Your physician will probably suggest a non-steroidal anti-inflammatory pill that is available over the counter: Aspirin, ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn). Gentle massage may also be useful.

If you don’t respond to the non-prescription painkillers, your doctor may inject a corticosteroid into the shoulder joint or the surrounding tissue.

Concurrently, you should be working with a physical therapist to stretch the joint capsule and, later, to strengthen the surrounding muscles. Physiotherapy is a major key to recovery; your physiotherapist will determine how far you can push yourself and teach you frozen shoulder exercises that you can ultimately practise at home, including both stretches and range of motion exercises for frozen shoulder. Sometimes, heat is applied to loosen the shoulder prior to exercise.

Surgery for Frozen Shoulder

In extreme cases, surgery may be required to loosen the shoulder capsule. This most commonly means either manipulation under anesthesia or arthroscopic surgery or a combination. During manipulation, the doctor forces shoulder movement, tearing scar tissue and allowing healing to begin. Arthroscopy requires small incisions to cut through the joint capsule to loosen it. Post-op rehab physical therapy is necessary after frozen shoulder surgery to maintain the gains that it achieved.

If you suspect that you are suffering from frozen shoulder, consult with your physician so that the proper course of treatment can be followed. After all, it’s no fun to ask for help in reaching objects on a high shelf or putting on your coat.

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