Frozen Shoulder

Frozen shoulder or adhesive capsulitis is a shoulder condition causing limited range of motion. This condition occurs when the tissues in the shoulder joint become thicker and tighter. The common signs and symptoms of frozen shoulder may include stiffness and pain in the shoulder joints which usually get worsened within one to three years. Treatment for the frozen shoulder may include physical therapy, medications, surgery and other procedures.

Symptoms

Signs and symptoms of frozen shoulder are normally worsened and developed over time. They are divided into three stages including:

• Freezing stage

People with this stage of frozen shoulder usually have pain when moving the shoulder that limits the range of motion.

• Frozen stage

During this stage, the pain may be relieved but the shoulder becomes stiffer and more difficult to use.

• Thawing stage

The range of motion is more limited. Moving the shoulder is obviously more difficult for people with this final stage of frozen shoulder.

Causes

A capsule of connecting tissue encases the shoulder joint. When these connecting tissues become thicker and tighter, the movement of the shoulder is restricted. The reason why the tissues get thicken and tighten are still unclear. However, systemic diseases and immobilizing the shoulder for a long period, such as in people after a surgery or arm fracture tend to be involved with the development of this condition.

Risk factors

There are several factors that might increase the risk of frozen shoulder including:

• Age and gender

Women at the age of 40 and older tend to have more risk of frozen shoulder.

• Immobilized or less mobilized shoulder

The risk of frozen shoulder is increased in people who have prolonged immobility or less mobility of the shoulder. The cause of immobility or less mobility of the shoulder may include broken arm, recovery after a surgery, injury or stroke.

• Systemic diseases

Some systemic diseases may encourage the development of frozen shoulders. For example:

• • Diabetes
  • Hypothyroidism
  • Hyperthyroidism
  • Cardiovascular disease
  • Parkinson's disease
  • Tuberculosis

Diagnosis

The doctor may conduct a physical exam to check for the pain and evaluate active and passive range of motion since either of them can be affected. A numbing medicine might be injected in some cases. Normally, a frozen shoulder can be diagnosed by the physical exam and reviewing of signs and symptoms. However, to seek for other problems, the doctor may require to use some image tests, such as X-rays or MRI.

Treatment

The aims of the treatment are to control the pain and improve a better range of motion. Medications, therapy, surgery and some procedures are the common treatments of frozen shoulders.

• Medications

The doctor may prescribe several medications, such as pain reliever and anti-inflammatory drugs to relieve the pain and inflammation.

• Therapy

The doctor or a physical therapist may advise you on some range-of-motion exercise to promote the mobility of the shoulder.

• Surgical and other procedures

Other treatment for frozen shoulder may include:

• • Steroid injection. To reduce pain and promote shoulder mobility
  • Joint distension. To stretch the connecting tissues and to promote an easier movement
  • Shoulder manipulation. To loosen the tighten tissue
  • Surgery. The doctor may perform a surgery to remove a scar tissue and adhesions inside the shoulder joint in people who do not react to other treatment.

Preparing for an appointment

Before your appointment,  you are advised to be aware of restrictions prior the appointment and you may prepare some information including:

• your experienced symptoms
• your key personal information
• all medications you are taking
• questions that you want to ask the doctor

During the consulting, the doctor may ask some questions including the information such as:

• the beginning of your symptoms
• whether anything improve or worsen your symptoms
• your experience of shoulder injury
• whether you have diabetes or other systemic disease
• your experience of recent surgery
• the periods of restricted shoulder motion