FROZEN SHOULDER also called ADHESIVE CAPSULITS OR PERIARTHRITIC SHOULDER. It causes pain and stiffness in the shoulder. Overtime shoulder becomes very hard to move. In frozen shoulder the shoulder capsule thickens and becomes stiff and tight. In many of the cases, there is less synovial fluid in the joint. The important sign of this condition are severe pain which unable to move shoulder.
Stage 1: Freezing
In the “freezing” stage, there is feeling of more and more pain. As the pain worsens, shoulder loses its range of motion. Freezing typically lasts from 6 weeks to 9 months.
Stage 2: Frozen
In frozen stage Painful symptoms may actually improves but stiffness remains. During the 4 to 6 months of the “frozen” stage, the ADL OR ACTIVITIES OF DAILY LIVING may be very difficult.
Stage 3: Thawing
In this stage Shoulder motion slowly improves. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.
The cause of Frozen shoulder is not clear till now. Frozen shoulder happens when the tissue around the shoulder joint becomes inflamed. The tissue then gets tighter and shrinks which causes pain. There is no clear connection to arm dominance or occupation. A few factors may put you more at risk for developing frozen shoulder.
Diabetes- Frozen shoulder occurs mostly in people with diabetes. The reason for this is not known. Diabetic patients with frozen shoulder tend to have a greater degree of stiffness that continues for a longer time before “thawing stage.”
Some additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson’s disease and cardiac disease.
Immobilization – Frozen shoulder can develop after a shoulder has been immobilized for a long period of time due to surgery, a fracture, or other injury. Patients move their shoulders soon after injury or surgery is one measure.
Pain and stiffness is the main symptom that make it difficult or impossible to move the arm. If the person is suffering from frozen shoulder, it is likely to feel a dull or achy pain in one shoulder. Patient might feel the pain in the shoulder muscles that wrap around the top of arm. The pain could get worse at night, which can make it hard to sleep.
Doctor will move shoulder carefully in all directions to see if movement is limited and also pain occurs with the motion.
The range of motion when someone else moves shoulder is called “passive range of motion.” The doctor will compare Passive range of Motion with the patient actual range of motion (active range of motion).
People with frozen shoulder have limited range of motion both actively and passively.
There are certain exercise which are done to decrease pain and increase range of motion. Therapy includes stretching or range of motion exercises for the shoulder. Sometimes heat is used to help loosen the shoulder up before stretching. Below are examples of some of the exercises that might be recommended.
Therapy includes stretching or range of motion exercises for the shoulder. Sometimes heat is used to help loosen the shoulder up before stretching. Below are examples of some of the exercises that might be recommended.
● External rotation —It should be a passive stretch. Stand in a doorway and bend your affected arm’s elbow to 90 degrees to reach the doorjamb. Keep your hand in place and rotate your body as shown in the illustration. Hold for 30 seconds. Relax and repeat.
● Forward flexion —This is performed in supine position. Lie on your back with your legs straight. Use your unaffected arm to lift your affected arm overhead until you feel a gentle stretch. Hold for 15 seconds and slowly lower to start position. Relax and repeat.
● Crossover arm stretch. Gently pull one arm across your chest just below your chin as far as possible without causing pain. Hold for 30 seconds. Relax and repeat.
● Pendulum stretch: Stand with the shoulders relaxed. Lean forward with the hand of the unaffected arm resting on a table. Let the affected arm hang down vertically and swing in a small circle, around 1 foot in diameter. Increase the diameter over several days, as you gain strength.
● Towel stretch: Grab both ends of a towel behind your back. With the good arm, pull the towel, and the affected arm, up toward the shoulder. Repeat 10 to 20 times a day.
● Modalities like TENS/IFT ,ultrasonic therapy ,hot pack are given to reduce pain along with exercise.
● Once the pain has been reduced and patient gain its maximum range of moton the theraband and dumbells are also used for further strengthening of shoulder joint and its muscles around it.
To treat the pain and reduce joint inflammation, your doctor may recommend an anti- inflammatory medication like aspirin, ibuprofen, or naproxen sodium. A
steroid injection may also reduce pain in severe condition.