Frozen Shoulder (Adhesive Capsulitis) is a condition that causes stiffness and pain in the shoulder joint. The shoulder joint is surrounded by a capsule of connective tissue, and in frozen shoulder, this capsule becomes thickened and tight, leading to restricted movement and intense discomfort. The condition usually develops gradually and can last for several months to a few years if left untreated.
Stages of Frozen Shoulder:
Frozen shoulder typically progresses in three stages:
- Freezing Stage (Painful Stage):
- Symptoms: The shoulder begins to hurt, and pain may worsen over time, particularly when moving the shoulder. The pain is often dull or aching and may be felt both at rest and during movement.
- Duration: This stage can last from 6 weeks to 9 months.
- Frozen Stage (Stiffness Stage):
- Symptoms: Pain may start to decrease, but the shoulder becomes increasingly stiff. Movement becomes severely limited, and daily activities such as dressing or reaching overhead can become challenging.
- Duration: This stage can last from 4 months to a year.
- Thawing Stage (Recovery Stage):
- Symptoms: Gradual improvement in shoulder motion and reduction in pain. The shoulder's range of motion slowly increases, and normal function is restored.
- Duration: This stage can last from 6 months to 2 years.
Causes of Frozen Shoulder:
The exact cause of frozen shoulder is not always clear, but the condition is associated with the following factors:
- Injury or Surgery: Shoulder injuries, such as fractures or rotator cuff tears, or surgery around the shoulder can trigger frozen shoulder due to prolonged immobilization or lack of movement.
- Medical Conditions: Certain conditions can increase the risk of developing frozen shoulder, including:
- Diabetes: People with diabetes are at a higher risk for frozen shoulder, possibly due to changes in the blood vessels and tissue healing.
- Thyroid Disorders: Conditions like hypothyroidism or hyperthyroidism may be linked to an increased risk.
- Heart Disease: Some heart-related conditions can contribute to the development of frozen shoulder.
- Parkinson’s Disease: Individuals with Parkinson’s may experience a higher incidence of shoulder problems, including frozen shoulder.
- Age and Gender: Frozen shoulder is most common in people between the ages of 40 and 60, with women being more likely to develop the condition than men.
- Immobility: Prolonged immobility or inactivity of the shoulder joint after an injury, surgery, or illness can contribute to the development of frozen shoulder.
Symptoms of Frozen Shoulder:
- Pain: The pain can range from mild to severe and is typically felt in the outer shoulder or upper arm. The pain can worsen with movement, especially overhead activities.
- Stiffness: The primary symptom is restricted range of motion in the shoulder, making it difficult to perform everyday activities such as reaching, lifting, or rotating the arm.
- Limited Function: As the condition progresses, the shoulder’s ability to move freely is significantly reduced. Movements such as combing hair, reaching for objects, or even sleeping on the affected side may become painful or impossible.
Diagnosis:
A healthcare provider typically diagnoses frozen shoulder through:
- Physical Exam: The doctor will assess the range of motion and test the shoulder for signs of pain and stiffness.
- Imaging: X-rays or MRI may be used to rule out other conditions such as rotator cuff tears, arthritis, or fractures, as they have similar symptoms to frozen shoulder.
Treatment for Frozen Shoulder:
Treatment aims to reduce pain, improve range of motion, and restore shoulder function. Options include:
- Conservative Treatments:
- Physical Therapy: A key treatment for frozen shoulder. Physical therapy involves stretching and strengthening exercises that help improve shoulder mobility and reduce stiffness.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and inflammation. In some cases, corticosteroid injections may be used to reduce inflammation and alleviate pain.
- Heat and Ice Therapy: Applying ice or heat can help reduce pain and inflammation, especially during the early stages of the condition.
- Invasive Treatments (for persistent cases):
- Hydrodilatation: Involves injecting a sterile solution (water, saline, and sometimes corticosteroids) into the shoulder joint to help stretch the capsule and improve range of motion.
- Shoulder Manipulation: Under anesthesia, the doctor may move the shoulder joint forcefully to break up adhesions and scar tissue.
- Surgery: If conservative methods don’t work, a surgeon may perform arthroscopic surgery to remove the thickened tissue (capsular release) and restore motion.
- Recovery and Rehabilitation:
- Ongoing Physical Therapy: After interventions, continuous physical therapy is crucial to regain strength and full motion.
- Patience: The condition typically improves over time, but it can take several months to years for full recovery.
Prevention:
While frozen shoulder cannot always be prevented, certain measures can help reduce the risk:
- Regular Shoulder Exercises: Keeping the shoulder joint flexible and strong through regular stretching and strengthening exercises can help.
- Early Treatment of Injuries: Prompt treatment of shoulder injuries or conditions that cause immobility can reduce the likelihood of developing frozen shoulder.
