Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. It typically develops gradually and can significantly limit the range of motion, making everyday activities challenging. While the exact cause of frozen shoulder is not fully understood, it often occurs after an injury or surgery that immobilizes the shoulder for an extended period. Fortunately, several therapies can help alleviate the symptoms and improve shoulder mobility.
Frozen shoulder, or adhesive capsulitis, typically presents with a few key signs and symptoms.
These symptoms usually develop gradually and can be divided into three stages: the freezing stage, the frozen stage, and the thawing stage. Here are the main signs to look out for:
1. Pain
- Dull or Aching Pain: The pain is often described as a dull or aching sensation in the shoulder. It can also radiate down the arm and into the upper arm muscles.
- Worsening Pain with Movement: Any movement of the shoulder can exacerbate the pain, making it difficult to perform daily activities.
- Night Pain: Pain can be worse at night, sometimes disturbing sleep.
2. Stiffness
- Limited Range of Motion: The shoulder becomes increasingly stiff, making it hard to move. This stiffness can affect both active and passive range of motion13.
- Difficulty with Everyday Tasks: Activities such as dressing, bathing, and reaching overhead become challenging due to the stiffness.
3. Progressive Stages
- Freezing Stage: This initial stage lasts from 2 to 9 months. Pain gradually increases, and the shoulder’s range of motion starts to decrease.
- Frozen Stage: During this stage, which can last from 4 to 12 months, pain may begin to diminish, but the shoulder remains stiff. Movement becomes more restricted.
- Thawing Stage: The final stage can last from 5 to 24 months. The shoulder’s range of motion slowly begins to improve.
4. Functional Impairment
- Difficulty Performing Daily Activities: The combination of pain and stiffness makes it hard to carry out normal shoulder movements, affecting tasks like driving, lifting objects, and even sleeping comfortably.
5. Muscle Weakness
- Reduced Strength: Due to the limited use of the shoulder, muscles around the shoulder joint may weaken over time.
If you notice these signs, it’s important to consult a healthcare provider for an accurate diagnosis and appropriate treatment plan. Early intervention can help manage symptoms and improve shoulder function.
Frozen shoulder, or adhesive capsulitis, can develop due to several factors. Here are some of the most common ones:
- Age and Gender: People over the age of 40 are more likely to develop frozen shoulder, with women being more commonly affected than men.
- Immobility or Reduced Mobility: Keeping the shoulder still for a prolonged period, such as after surgery, an injury, or a stroke, can increase the risk. Conditions like rotator cuff injuries or fractures that limit shoulder movement can also contribute.
- Systemic Diseases: Certain systemic diseases are associated with a higher risk of frozen shoulder. These include:
- Diabetes: People with diabetes are at a significantly higher risk, though the exact reason is not fully understood.
- Thyroid Disorders: Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can increase the risk.
- Cardiovascular Disease: Heart disease can also be a contributing factor.
- Parkinson’s Disease: This neurological condition is another risk factor.
- Other Health Conditions: Conditions like Dupuytren’s contracture, which affects the hands and fingers, can also increase the likelihood of developing frozen shoulder.
- Previous Shoulder Injuries or Surgeries: A history of shoulder injuries or surgeries can predispose someone to frozen shoulder, especially if the shoulder was immobilized during recovery.
Understanding these risk factors can help in early identification and management of frozen shoulder, potentially preventing severe stiffness and pain. If you think you might be at risk, it’s a good idea to discuss preventive measures with your healthcare provider.
Preventing frozen shoulder involves maintaining shoulder mobility and addressing underlying health conditions.
Here are some effective preventive measures:
1. Regular Exercise
Engaging in regular, targeted exercises can help maintain shoulder flexibility and strength. Focus on exercises that promote shoulder mobility, such as:
- Arm Circles: Gently rotate your arms in small circles to keep the shoulder joint active.
- Wall Walks: Stand facing a wall and “walk” your fingers up the wall to stretch the shoulder.
- Pendulum Stretches: Lean forward and let your arm hang down, then gently swing it in small circles.
2. Avoid Prolonged Immobility
Keeping the shoulder still for long periods can increase the risk of developing frozen shoulder. If you’ve had surgery or an injury, follow your healthcare provider’s recommendations for gentle, progressive range-of-motion exercises to keep the shoulder moving.
3. Ergonomic Adjustments
Ensure your work and home environments are set up to avoid unnecessary strain on your shoulders. This includes:
- Proper Desk Setup: Adjust your chair and desk height to keep your shoulders relaxed while working.
- Lifting Techniques: Use proper techniques when lifting objects to avoid shoulder strain.
4. Manage Underlying Health Conditions
Certain conditions, such as diabetes and thyroid disorders, can increase the risk of frozen shoulder. Managing these conditions effectively can help reduce the risk:
- Diabetes Management: Keep blood sugar levels under control through diet, exercise, and medication.
- Thyroid Health: Regular check-ups and appropriate treatment for thyroid disorders can help maintain overall health.
5. Early Intervention
If you start to notice any stiffness or pain in your shoulder, seek medical advice early. Early intervention can prevent the condition from worsening and help maintain shoulder mobility.
By incorporating these preventive measures into your routine, you can reduce the risk of developing frozen shoulder and maintain healthy shoulder function.
Here are five effective therapies for treating frozen shoulder
1. Physical Therapy
Physical therapy is one of the most common and effective treatments for frozen shoulder. A physical therapist will design a personalized exercise program to help improve the range of motion and reduce pain. The therapy typically includes:
- Stretching Exercises: These exercises aim to gently stretch the shoulder muscles and improve flexibility. Common stretches include the pendulum stretch, towel stretch, and cross-body reach.
- Strengthening Exercises: Once the range of motion improves, strengthening exercises are introduced to build shoulder strength and stability. These exercises often involve resistance bands or light weights.
- Manual Therapy: Physical therapists may use hands-on techniques to mobilize the shoulder joint and reduce stiffness. This can include joint mobilization and soft tissue massage.
Regular physical therapy sessions, combined with a home exercise program, can significantly improve shoulder function over time1.
2. Medications
Medications can help manage the pain and inflammation associated with frozen shoulder. Commonly used medications include:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter NSAIDs like ibuprofen and naproxen can help reduce pain and inflammation.
- Corticosteroids: These are powerful anti-inflammatory medications that can be taken orally or injected directly into the shoulder joint. Corticosteroid injections can provide quick relief from pain and improve mobility, but their effects are usually temporary2.
- Pain Relievers: Acetaminophen or prescription pain relievers may be recommended for managing severe pain.
It’s important to use medications as directed by a healthcare provider to avoid potential side effects.
3. Heat and Cold Therapy
Applying heat or cold to the shoulder can help alleviate pain and reduce inflammation. This therapy is often used in conjunction with other treatments:
- Heat Therapy: Applying a warm compress or heating pad to the shoulder can help relax tight muscles and improve blood flow. This can be particularly beneficial before stretching exercises.
- Cold Therapy: Using an ice pack or cold compress can help reduce inflammation and numb the area, providing pain relief. Cold therapy is often recommended after physical activity or exercise to prevent swelling3.
Alternating between heat and cold therapy can be an effective way to manage symptoms.
4. Hydrodilatation
Hydrodilatation, also known as distension arthrography, is a minimally invasive procedure used to treat frozen shoulder. During this procedure, a healthcare provider injects a sterile saline solution, along with a corticosteroid and a local anesthetic, into the shoulder joint. The solution helps stretch the joint capsule, breaking up adhesions and improving the range of motion.
Hydrodilatation is typically performed under imaging guidance, such as ultrasound or fluoroscopy, to ensure accurate placement of the injection. This procedure can provide significant pain relief and improve shoulder mobility, often with immediate results4.
5. Surgery
Surgery is usually considered a last resort for treating frozen shoulder when other therapies have failed to provide relief. There are two main surgical options:
- Manipulation Under Anesthesia (MUA): During this procedure, the patient is put under general anesthesia, and the surgeon forcibly moves the shoulder to break up adhesions and improve the range of motion. MUA can be effective, but it carries risks such as fractures or dislocations.
- Arthroscopic Surgery: This minimally invasive surgery involves making small incisions around the shoulder and using a camera and specialized instruments to remove scar tissue and adhesions. Arthroscopic surgery is generally safer and has a shorter recovery time compared to open surgery5.
Post-surgery, physical therapy is essential to maintain the improvements in shoulder mobility and prevent recurrence.
Conclusion
Frozen shoulder can be a debilitating condition, but with the right combination of therapies, it is possible to manage symptoms and restore shoulder function. Physical therapy, medications, heat and cold therapy, hydrodilatation, and surgery are all effective treatments that can help patients regain their quality of life. It’s important to work closely with a healthcare provider to develop a personalized treatment plan that addresses individual needs and goals.
By staying proactive and committed to the treatment plan, individuals with frozen shoulder can achieve significant improvements and return to their daily activities with less pain and greater ease.
Source:
1: Harvard Health 2: Mayo Clinic 3: Penn Medicine 4: NHS 5: Shoulder Savvy