Frozen shoulder is also known as adhesive capsulitis. The shoulder joint’s capsule becomes inflamed and stiff resulting in severe restrictions to movement and chronic pain.
This is a very frustrating condition as there is no exact cause known, sudden movements can cause immense pain and even the simplest task can become a challenge. The condition can also lead to problems in the neck/back and depression.
The inflammation in the capsule results in swelling with thickening and tightening due to the bands of scar tissue developing within the capsule. In addition, there is less synovial fluid (lubrication) within the joint space leading to further restriction of movement and pain.
People suffering from heart disease, rheumatoid arthritis, lung disease, stroke or diabetes are at greater risk for developing frozen shoulder. It is more common in woman and usually occurs after the age of 40.
The condition presents with a progressive loss of active and passive ranges of motion. The pain is usually constant and worse during cold weather and at night. External rotation is the movement that is most restricted.
Frozen shoulder is suspected when there is very little difference between the active and passive ranges of motion.
Three stages of the normal course of this condition are described:
-Freezing (6 weeks – 9 months of increasing pain and reducing range of motion)
-Frozen (4 – 9 months of minimal improvements in pain and no change in stiffness)
-Thawing (5 – 26 months of slow recovery to +/- 90% of original range of motion).
The key is to start with mobilisation long before the symptoms become severe. Frequent and full range of (all 6 shoulder) movements prevent the formation of scar tissue and keeps the joint well lubricated. Physiotherapy (which may last for months) can help maintain these movements and manage the pain along with anti-inflammatory medication and possible cortisone injections. Patients also have the option of having a shoulder manipulation under anaestheia to break down the scar tissue but while this could improve the current state of the shoulder, it does not guarantee a quicker recovery.
Shoulder and Arm
Elbow and Forearm
Wrist and Hand
Upper Back and Chest
Hip and Thigh
Knee and Leg
Ankle and Foot
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