Frozen shoulder

Frozen shoulder, medically known as adhesive capsulitis, is a condition characterized by stiffness, pain, and limited range of motion in the shoulder joint. Understanding its causes, symptoms, and treatment options is crucial for managing this debilitating condition effectively.

Stage of Frozen Shoulder:

1. Freezing Stage (Painful Stage):

• This initial stage is marked by increasing shoulder pain, especially with movemen

• Range of motion in the shoulder joint gradually decreases, and it becomes progressively more difficult to perform daily activities that involve shoulder movement.

• Pain may be particularly intense at night, disrupting sleep.

• This stage can last anywhere from a few weeks to several months..

2. Frozen Stage (Stiffness Stage):

• During this stage, shoulder stiffness becomes more pronounced, and the range of motion becomes significantly limited.

• Pain may decrease compared to the freezing stage but can still be present, especially at the extremes of motion.

• Activities such as reaching overhead or behind the back become extremely difficult or impossible.

• This stage can last anywhere from 4 to 12 months.

3. Thawing Stage (Stiffness Stage):

• In this final stage, the shoulder gradually begins to regain mobility, and the stiffness and pain start to diminish.

• Range of motion slowly improves, allowing for a gradual return to normal activities.

• Some residual stiffness and discomfort may persist, but they are typically much less severe than in the previous stages.

• Full recovery can take several months to years, depending on factors such as individual response to treatment and the severity of the condition.

Causes of Frozen Shoulder:

• Inflammation:

Inflammation of the shoulder joint's lining (synovium) can lead to the formation of scar tissue, which restricts movement and causes stiffness.

• Systemic Diseases:

Certain systemic diseases and medical conditions, such as diabetes, thyroid disorders, Parkinson's disease, and cardiovascular disease, have been associated with an increased risk of frozen shoulder. The exact mechanisms through which these conditions contribute to frozen shoulder are not fully understood but likely involve inflammation and altered tissue healing processes.

• Trauma or Injury:

Trauma to the shoulder, such as a fracture or soft tissue injury, can lead to inflammation and subsequent adhesive capsulitis.

• Age and Gender:

Frozen shoulder tends to occur more frequently in people aged 40 and older, and it is more common in women than in men.

Symptoms of Frozen Shoulder:

• Pain:

Persistent dull or aching pain in the shoulder that may worsen at night, especially during the early stages of the condition. The pain is often located deep within the shoulder joint and may radiate to the upper arm or neck.

• Stiffness:

Gradual onset of stiffness in the shoulder joint, making it difficult to move the arm in certain directions. Initially, stiffness may be mild and limited to specific movements, but it progressively worsens, eventually restricting almost all shoulder movements.

• Painful Movement:

Movement of the shoulder joint becomes increasingly painful, particularly when reaching overhead, reaching behind the back, or lifting objects. The pain may worsen with certain movements and may be accompanied by a sensation of pulling or stretching in the shoulder.

• Muscle Weakness:

Weakness or muscle atrophy (loss of muscle mass) in the muscles surrounding the shoulder joint may develop over time due to disuse or limited mobility. This can further contribute to functional limitations and difficulty performing daily activities.

Treatment of Frozen Shoulder:

1. Pain Management:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be prescribed to reduce pain and inflammation.

• Acetaminophen (paracetamol) may be recommended for pain relief, especially for individuals who cannot tolerate NSAIDs..

2. Physical Therapy:

• Physical therapy plays a crucial role in managing frozen shoulder. A physical therapist can provide exercises and stretches aimed at improving shoulder mobility, reducing stiffness, and strengthening the muscles surrounding the shoulder joint.

• Manual therapy techniques such as joint mobilization and soft tissue massage may be used to help improve joint mobility and reduce pain.

3. Steroid Injections:

• Corticosteroid injections directly into the shoulder joint can help reduce inflammation and alleviate pain. These injections are typically administered under ultrasound guidance to ensure accurate placement.

• Steroid injections are often used in conjunction with physical therapy to optimize outcomes.

4. Home Exercises and Self-Care:

• Performing prescribed exercises and stretches at home can help maintain and improve shoulder mobility between physical therapy sessions.

• Applying heat or cold packs to the shoulder may help alleviate pain and reduce inflammation..

5. Hydrodilatation (Hydrodistension):

• This procedure involves injecting a sterile saline solution into the shoulder joint to distend the capsule and break up adhesions. Hydrodilatation can help improve shoulder mobility and reduce pain, particularly in individuals who have not responded to other treatments.