Frozen shoulder
What is frozen shoulder?
Frozen shoulder, clinically known as adhesive capsulitis, is a condition characterized by the gradual and progressive stiffness and pain in the shoulder joint. The term "frozen shoulder" describes the limited range of motion and stiffness that often develops over time. This condition typically progresses through distinct stages and can be associated with varying degrees of pain and functional impairment.
What causes frozen shoulder?
The exact cause of frozen shoulder (adhesive capsulitis) is not always clear, and the condition can develop spontaneously without an obvious trigger. However, several factors and conditions may contribute to the development of frozen shoulder. Common factors associated with frozen shoulder include:
Inflammation and Adhesions:
Frozen shoulder is characterized by inflammation and the formation of adhesions (abnormal bands of tissue) within the shoulder joint capsule.
Inflammation and adhesions can lead to the tightening and thickening of the capsule, restricting the normal movement of the shoulder joint.
Immobility or Lack of Use:
Prolonged immobility or lack of use of the shoulder joint can contribute to the development of frozen shoulder.
Conditions or situations that limit the ability to move the shoulder, such as recovering from surgery, recovering from an injury, or having a medical condition that affects mobility, may increase the risk.
Underlying Medical Conditions:
Certain medical conditions are associated with an increased risk of developing frozen shoulder. These conditions include:
Diabetes: People with diabetes are more prone to developing frozen shoulder.
Thyroid disorders: Conditions affecting the thyroid gland may contribute.
Cardiovascular disease: Some studies suggest a link between cardiovascular disease and frozen shoulder.
Previous Shoulder Injury or Surgery:
A history of shoulder injuries, trauma, or surgeries may increase the likelihood of developing frozen shoulder.
Postoperative immobility or reduced use of the shoulder during recovery can contribute to adhesions and stiffness.
Age and Gender:
Frozen shoulder is more common in individuals aged 40 to 60 years.
Women are more often affected than men.
Genetic Factors:
There may be a genetic predisposition to developing frozen shoulder, as it sometimes occurs in families.
Systemic Diseases:
Certain systemic diseases or autoimmune conditions may be associated with an increased risk of frozen shoulder.
Hormonal Changes:
Hormonal changes, such as those occurring during menopause, may influence the development of frozen shoulder.
It's important to note that in many cases, frozen shoulder develops without an obvious cause, and multiple factors may interact in its development
What are signs and symptoms of frozen shoulder?
Frozen shoulder, or adhesive capsulitis, is characterized by a gradual onset of symptoms that typically progress through stages. The condition involves pain, stiffness, and a limited range of motion in the shoulder joint. The signs and symptoms may vary among individuals, but common features include:
Pain:
The initial symptom is often pain in the shoulder, which may develop gradually.
The pain is typically located deep in the shoulder joint and may be more pronounced at night.
Stiffness:
Stiffness is a hallmark feature of frozen shoulder and tends to worsen over time.
The stiffness is characterized by a gradual loss of range of motion in the shoulder joint.
Limited Range of Motion:
Individuals with frozen shoulder may experience a progressive reduction in the ability to move the affected shoulder.
Difficulty reaching overhead, reaching behind the back, or performing routine activities like combing hair or putting on a shirt may become noticeable.
Pain with Movement:
Pain is often exacerbated by movement of the shoulder joint.
Certain motions, especially those involving lifting the arm or reaching, may elicit sharp or aching pain.
Night Pain:
Pain at night is a common symptom, and individuals with frozen shoulder may find it challenging to sleep comfortably on the affected side.
Gradual Onset:
Symptoms typically develop gradually over weeks or months rather than appearing suddenly.
Three Stages:
Frozen shoulder often progresses through three stages: the freezing stage, the frozen stage, and the thawing stage.
In the freezing stage, pain is the predominant symptom. The frozen stage is characterized by increased stiffness and limited range of motion. The thawing stage involves a gradual improvement in symptoms.
Pain Relief in Certain Positions:
Some individuals may find temporary relief from pain by supporting the affected arm or finding specific comfortable positions.
Functional Impairment:
As the condition progresses, functional impairment of the shoulder can impact daily activities and tasks that involve shoulder movement.
It's important to note that the severity and duration of symptoms can vary among individuals. Frozen shoulder is a self-limiting condition, meaning it typically improves over time, but the process can take several months to years.
How do you treat frozen shoulder?
The treatment of frozen shoulder typically involves a combination of conservative measures aimed at relieving symptoms and improving shoulder mobility. The goal of treatment is to manage pain, reduce inflammation, and gradually restore range of motion. Here are common approaches to treating frozen shoulder:
Pain Management:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may be prescribed to reduce pain and inflammation.
Soft Tissue Therapy (Massage, Myofascial Release, Cupping, ART, FR, etc.)
While the primary focus in treating frozen shoulder involves addressing the joint capsule and range of motion, soft tissue therapy can help alleviate muscle tightness, reduce pain, and improve overall shoulder function.
Chiropractic Joint Mobilization and Manipulation:
Manual therapy techniques, including joint mobilization, may be used to improve joint mobility.
Patient Education:
Educating the patient about the condition, the importance of adherence to exercises, and the expected course of recovery is an integral part of treatment.
Rehabilitative Exercise:
Exercise and stretching play a crucial role in the treatment of frozen shoulder.
Therapists can design specific exercises to improve shoulder mobility.
Range of motion exercises may include pendulum exercises, stretching exercises, and active or passive range of motion activities.
Home Exercises:
Patients are often prescribed a home exercise program to continue stretching and strengthening exercises between therapy sessions.
Activity Modification:
Avoiding activities that worsen symptoms or exacerbate pain is important during the acute phase.
Gradual reintroduction of activities is typically recommended as symptoms improve.
Monitoring and Follow-Up:
Regular monitoring and follow-up with healthcare providers are essential to assess progress and make necessary adjustments to the treatment plan.
It's important for individuals with frozen shoulder to work closely with their healthcare team to develop a personalized treatment plan that addresses their specific needs and challenges. The duration of treatment can vary, and patience is often required as the condition typically improves gradually over time.
How long does it take for frozen shoulder to resolve?
While the total duration of frozen shoulder can vary, the overall timeframe for resolution is often around 1 to 3 years. However, individual experiences may differ, and some people may recover more quickly or take longer to achieve full resolution.
Factors that can influence the duration and severity of frozen shoulder include:
Age: Younger individuals may recover more quickly than older individuals.
Presence of Underlying Conditions: Certain medical conditions, such as diabetes or thyroid disorders, may be associated with a longer duration of symptoms.
Treatment Approach: The effectiveness of conservative treatments, such as physical therapy/chiropractic/massage therapy, exercises, and anti-inflammatory medications, can influence recovery time.