What is Frozen Shoulder ?
Frozen shoulder or adhesive capsulitis is a common source of shoulder pain. The more precise medical term for a frozen shoulder is "adhesive capsulitis".
In basic terms, it means that your shoulder pain and stiffness is a result of shoulder capsule inflammation (capsulitis) and fibrotic adhesions that limit your shoulder movement.
While frozen shoulder is commonly missed or confused with a rotator cuff injury, it has a distinct pattern of symptoms resulting in severe shoulder pain, loss of shoulder function and eventually stiffness.
How Common is Frozen Shoulder ?
Most cases of frozen shoulder occur in people between the ages of 40 and 60. The condition is more common in Women than Men. It is estimated that a frozen shoulder could affect up to 1 in 20 people.
The exact cause of frozen shoulder is not fully understood, although it appears to be more common in people with certain health conditions, such as diabetes (a long-term condition that is caused by too much glucose in the blood).
What Causes Frozen Shoulder ?
Unfortunately, there is still much unknown about frozen shoulder. One of those unknowns is why frozen shoulder starts. There are many theories but the medical community still debates what actually causes frozen shoulder.
What is Known about Frozen Shoulder ?
Frozen shoulder causes your shoulder joint capsule to shrink, which leads to pain and reduced range of shoulder movement. Your shoulder capsule is the deepest layer of soft tissue around your shoulder joint, and plays a major role in keeping your humerus within the shoulder socket.
What are Frozen Shoulder Symptoms ?
Frozen shoulder has three stages, each of which has different symptoms.
The 3 Stages are:
- Freezing – characterised by pain around the shoulder initially, followed by a progressive loss of range of movement. Known as the RED phase due to the capsule colour if you undergo arthroscopic surgery.
- Frozen – minimal pain, with no further loss or regain of range. Known as the PINK phase due to the capsule colour if you undergo arthroscopic surgery.
- Thawing– gradual return of range of movement, some weakness due to disuse of the shoulder. Known as the WHITE phase due to the capsule colour if you undergo arthroscopic surgery.
Each stage can last on average 6 to 8 months if left untreated.
What are the Treatment Options ?
➢ Conservative Management:
Hot Water/ Ice Bags
You can also try using hot water fomentation for heat therapy or cold packs for cryotherapy, as per case specificity.
Monitoring Blood Sugar Levels
Frozen shoulder is a very common condition in chronic diabetics. Keeping the blood sugar levels in check limits the worsening of the frozen shoulder.
➢ Medical Management:
Anti-inflammatory drugs are commonly advised in many cases to relieve the pain as well as subside the inflammation observed in the early stages.
Physiotherapy is the most recommended and effective treatment for Frozen Shoulder. Once stiffness is more of a problem than pain, Physiotherapy is indicated. You will be shown specific exercises to try and get the ball and socket moving.
In addition, the physiotherapist may move the joint for you, trying to regain the normal glides and rolling of the joint. These are known as joint mobilizations.
As the recovery phase starts you will find that the movement
gradually increases. This, again, can be a useful time to have Physiotherapy to help maximize the movement.
This may be the last resort if all the above measures fail or if the individual has significant pain and stiffness. The individual may have to undergo a capsular release,
‘Manipulation under Anaesthetic’ (MUA) plus an arthroscopic procedure.
How Can Physiotherapist Help ?
Physiotherapists are highly skilled at assessing and treating people with frozen shoulder. Your physiotherapist will conduct a thorough examination to determine if you have frozen shoulder and its stage. Also at times there are other underlying conditions which may present themselves as frozen shoulder. It is important to understand the underlying pathology in such conditions and also its stage as treatment differs for each of it. A physiotherapist will help in the appropriate diagnosis and devise a treatment plan for the same. Even in specific cases of Frozen shoulder the level of mobilization as well as its timing is case specific. Mobilizing too early can worsen the pain, vice versa delayed mobilization can lead to more stiffness. Your physiotherapist will assess the stage of progression of the condition and will accordingly structure a treatment plan. Also administering physiotherapy treatment in time will save the patient from over medication which is very commonly observed in the form of over the counter pain killers.
At Arooj, we have an entire team of physiotherapists, who are well versed with the condition of Frozen shoulder as well as the latest techniques to recover the patient faster and avoid its recurrence and ultimately minimize the overall suffering. There have been many successful cases who have completely recovered from frozen shoulder by receiving regular physiotherapy treatment from Arooj.
For further information, please check the Arooj website or download our app from Google playstore or Apple appstore.