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Frozen Shoulder

Frozen Shoulder, Frozen Shoulder Treatment in Gurgaon, Frozen Shoulder Stages, Frozen Shoulder Treatment, treatment of Frozen Shoulder, frozen shoulder Diagnosis, frozen shoulder prevention, Prevent Frozen Shoulder

Overview

Adhesive capsulitis, commonly known as frozen shoulder is a common condition characterised by a painful and stiff shoulder joint. It can result in the loss of normal range of motion in the shoulder and can worsen with time without proper treatment.  

About The Condition

The shoulder has an extremely wide and varied range of motion, owing to its ball and socket arrangement (called glenohumeral joint) and complex connections between the joints, muscles, tendons and soft tissue. This enables the shoulder to move forward and backward and allows the arm to rotate and extend outward from the body.  

Frozen shoulders usually develop due to prolonged periods of immobilisation (caused by injury and/or inflammation of the connecting soft tissue). This results in the connective tissue surrounding the joint losing its elasticity and lubricating synovial fluid. In advanced cases, bands of scar tissue can also form further hampering movement. Symptoms of frozen shoulder usually show gradually worsening over time.

Risk factors for Frozen Shoulder

Risk factors that increase the likelihood of developing frozen shoulder include: 

  1. Age: Frozen shoulder is more common in adults between the age of 40 –60 years. 
  2. Gender: Frozen shoulder is more common in women as compared to men. Recent shoulder injury: Any injury or surgery that results in a prolonged period of immobilisation can result in a frozen shoulder. 
  3. Diabetes: Although the exact reasons are still unknown, it has been observed that individuals with diabetes mellitus are at a higher risk of developing frozen shoulder. Approximately 50% of diabetes mellitus patients are reported to develop frozen shoulder. 
  4. Conditions limiting mobility: Certain conditions such as stroke, hypothyroidism, hyperthyroidism, Parkinson’s disease and heart disease can result in the limited shoulder or arm movement increases the risk of developing frozen shoulder. 

Symptoms

Frozen shoulder is a condition that manifests gradually over time. Hence, its symptoms are classified into three stages depending on the progression of the condition.  

Frozen Shoulder, Frozen Shoulder Treatment in Gurgaon, Frozen Shoulder Stages, Frozen Shoulder Treatment, treatment of Frozen Shoulder, frozen shoulder Diagnosis, frozen shoulder prevention, Prevent Frozen Shoulder
  1. Freezing stage: This is the initial stage of the condition where the patient experiences pain and stiffness in the shoulder. It can worsen at night and the range of motion decreases with time. This stage lasts anywhere between 6 weeks to 9 months 
  2. Frozen stage: This stage is characterised by stiffness in the shoulder with decreased pain. It limits the individual’s ability to perform routine tasks and activities. The stage usually lasts for 2-6 months 
  3. Thawing stage: This stage shows improved movement with decreased pain and stiffness in the shoulder. Normal strength and motion can return with the right treatment. The stage usually lasts between 6 months to 2 years. 

Frozen Shoulder Diagnosis

Diagnosis of frozen shoulder is majorly done on the basis of your medical history and physical exam. Your doctor would also make you perform a range of physical exercises to evaluate the severity of the condition or to test your “passive range of motion” and “active range of motion”. Imaging tests such as X-ray and MRI are also done routinely to monitor the condition and rule out other conditions such as arthritis and rotator cuff tear.  

Frozen Shoulder Treatment

In the initial or “freezing” stage, treatment involves simple pain relief methods to relive the symptoms. These include: 

  1. Hot and cold compress. 
  2. Medications such as nonsteroidal anti-inflammatory drugs to reduce pain and inflammation 
  3. Physical therapy  
  4. Home exercises such as simple stretches and strengthening exercises to perform at home. These include:  
    1. Pendulum stretch- Stand and lean over slightly allowing the affected arm to hand down. Swing the arm in a small circle (10 revolutions in each direction). Slowly increase the diameter of the circle gradually as the movement range in your arm improves. Do not overexert your shoulder.  
    2. Towel stretch- Grab a three-foot-long towel with both hands behind your back and hold it in a horizontal position. Use your good arm to pull your affected arm upwards.  
    3. Cross body reach- Use your good arm to lift your affected arm at the elbow and bring it across your body, while exerting gentle pressure to stretch the shoulder. Hold the position for 15-20 seconds and repeat 10-20 times a day. 
    4. Outward and inward rotation- These exercises should be performed after you find significant improvement in your range of motion. For outward rotation, hold a rubber band between your hands and keep your elbows at a 90-degree bend close to your sides. Rotate the lower part of your affected arm outward as much as your shoulder allows and hold for 5 seconds. For inward rotation, hook the rubber band to an immobile source and pull it outward with your affected arm while bending it at a 90-degree angle (at the elbow). Repeat these exercises 10-15 times a day.  
Frozen Shoulder, Frozen Shoulder Treatment in Gurgaon, Frozen Shoulder Stages, Frozen Shoulder Treatment, treatment of Frozen Shoulder, frozen shoulder Diagnosis, frozen shoulder prevention, Prevent Frozen Shoulder

All these exercises should be performed under medical advisement.  

In case these treatments are not relieving symptoms of pain and stiffness, other procedures to treat this condition include:  

  1. Manipulation under anaesthesia: Your doctor will forcibly move the shoulder while you are under anaesthesia to stretch or loosen the joint capsule and increase the range of motion. 
  2. Shoulder arthroscopy: In this surgical procedure your doctor would insert small pencil-sized instruments thorough small cuts around your shoulder to loosen the joint capsule.  

Prevention

Frozen shoulder usually is a result of long periods of immobility in the shoulder. You can reduce the risk of developing it by diligently performing physical therapy after any trauma, surgery or condition limiting the movement of the shoulder. You can come up with a tailored physical therapy plan with the help of your physical therapist and orthopaedic doctor.    

FAQs

1. Will frozen shoulder heal itself?

Frozen shoulder can improve on its own over the course of 6 months to 18 months. Without treatment, there is also a higher risk of not regaining full-range motion.

2. Why does diabetes cause frozen shoulder?

Research shows that diabetic patients are twice as likely to develop frozen shoulder. However, the exact reasons behind this is still to be determined.

3. How long does it take for frozen shoulder to go away?

Frozen shoulder can take anywhere between 1-2 years to become better, depending on the severity and treatment. The pain and stiffness usually go away gradually with major or complete restoration of movement. Recovery period can be reduced significantly with the appropriate physical therapy.  

 
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