Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, also known as adhesive capsulitis, is a painful condition. It causes stiffness and limited mobility in the shoulder joint. This happens when the connective tissue around the shoulder joint gets inflamed and thickens.

This condition starts with inflammation and intense pain. As it progresses, stiffness grows, making daily activities hard. Treatment aims to manage pain, improve movement, and prevent complications.

Knowing the causes, risk factors, and treatments is key for those with frozen shoulder. With the right care and rehabilitation, it’s possible to regain shoulder function and reduce pain.

Understanding Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, also known as adhesive capsulitis, is a painful condition. It makes the shoulder stiff and limits its movement. Symptoms get worse over time. Knowing the stages of frozen shoulder helps in managing the condition and setting recovery goals.

What is Frozen Shoulder?

Frozen shoulder happens when the tissue around the shoulder joint gets inflamed and thick. This leads to scar tissue, making the joint capsule smaller. It causes stiffness and pain in the shoulder. The exact cause is not always known, but it’s more common in people with diabetes, thyroid disorders, or a history of shoulder immobilization.

Stages of Frozen Shoulder

Frozen shoulder goes through three stages:

In the freezing stage, shoulder pain and stiffness start slowly. The frozen stage follows, where pain might lessen but stiffness and limited movement stay. The thawing stage brings gradual improvement in mobility and pain reduction. The whole process can last from 12 to 42 months, with each person’s experience different.

Causes and Risk Factors

Many things can lead to frozen shoulder. Knowing what causes it helps people see if they might get it. This knowledge lets them take steps to avoid it.

Common Causes of Frozen Shoulder

One big reason for frozen shoulder is immobilization of the shoulder. This happens when an injury, surgery, or another condition keeps the arm in a sling or cast for a long time. The shoulder’s capsule gets stiff and thick, making it hard to move.

Some medical conditions raise the risk of frozen shoulder. Diabetes is a big risk factor, making diabetic patients more likely to get it. Thyroid disorders, like an underactive thyroid (hypothyroidism), also increase the risk.

Hormonal imbalances might also play a part. Women, mainly those going through menopause or experiencing hormonal changes, are more at risk than men.

Risk Factors for Developing Frozen Shoulder

Age is a big risk factor for frozen shoulder. People between 40 and 60 are most often affected. As we get older, our joints’ collagen becomes less flexible, making the shoulder stiffer and more inflamed.

Gender also affects the risk. Women are more likely to get frozen shoulder than men. The exact reasons for this are not fully understood.

Other things that might increase the risk of frozen shoulder include:

• Previous shoulder injuries or surgeries
• Cardiovascular disease
• Parkinson’s disease
• Dupuytren’s contracture (a condition that causes thickening of the skin on the palm)

By knowing these causes and risk factors, people can work with their doctors. Together, they can create a plan to prevent or manage frozen shoulder.

Symptoms and Diagnosis

Frozen shoulder, also known as adhesive capsulitis, can cause a lot of discomfort and make it hard to move the shoulder. It’s important to know the signs and symptoms and to use diagnostic tests to find out if you have it. This helps in creating a good treatment plan.

Identifying the Signs and Symptoms

The main symptoms of frozen shoulder include:

• Pain: A dull, aching pain that gets worse at night or when you move
• Stiffness: Trouble moving the shoulder, mainly in external rotation and abduction
• Limited range of motion: Hard to lift, rotate, or move the arm in different ways

These symptoms start slowly and can get worse over time. They make simple tasks like getting dressed, grooming, and reaching overhead very hard.

Diagnostic Tests and Procedures

Your healthcare provider will start with a detailed physical examination. They will check your shoulder’s range of motion, strength, and any tender spots. They might also suggest one or more imaging tests:

• X-rays: To check for other issues like arthritis or fractures
• MRI (Magnetic Resonance Imaging): To see the soft tissues around the shoulder joint
• Ultrasound: To look at the thickness and health of the shoulder capsule and rotator cuff tendons

By looking at the results from the physical exam and imaging tests, your healthcare provider can confirm frozen shoulder. They can then create a treatment plan that meets your specific needs and goals.

Non-Surgical Treatment Options

Frozen shoulder can be very painful and limit your movement. But, there are many non-surgical ways to help. These methods aim to reduce pain, inflammation, and improve your shoulder’s range of motion.

Physical Therapy and Stretching Exercises

Physical therapy is key in treating frozen shoulder. It uses gentle stretches to increase flexibility and mobility. A physical therapist will create a plan just for you to slowly improve your shoulder’s movement.

It’s important to stick with these exercises. Doing them regularly and patiently is essential for success. It also helps prevent the condition from getting worse.

Medications for Pain and Inflammation

There are medicines to help with frozen shoulder pain and swelling. Over-the-counter and prescription drugs like NSAIDs can reduce discomfort and swelling. Sometimes, stronger pain medicines are needed for more severe symptoms.

Corticosteroid Injections

Corticosteroid injections can help if you’re in a lot of pain and can’t move much. These injections are put directly into the shoulder joint. They help reduce inflammation and improve movement.

Even though the effects of these injections are short-lived, they can help. They give you a chance to do more physical therapy and stretching. This can lead to better long-term mobility.

Surgical Interventions

When non-surgical treatments don’t work, surgery might be needed for frozen shoulder. These surgeries aim to loosen the tight joint capsule. This helps restore the shoulder’s range of motion. The main surgeries for frozen shoulder are arthroscopic capsular release and manipulation under anesthesia.

Arthroscopic Capsular Release

Arthroscopic capsular release is a small surgery. It involves making small cuts around the shoulder. An arthroscope, a thin camera tool, is used to see inside the joint.

The surgeon then uses special tools to cut the tight parts of the joint capsule. This makes moving the shoulder easier.

The benefits of this surgery include:

• It’s a minimally invasive method.
• It precisely targets the tight joint capsule.
• Recovery is faster than open surgery.
• It has fewer risks of complications.

Manipulation Under Anesthesia

Manipulation under anesthesia (MUA) is another surgery for frozen shoulder. The patient is under general anesthesia during this procedure. The surgeon then moves the shoulder to break up tight adhesions.

This surgery can improve shoulder movement. But, it has higher risks than arthroscopic capsular release. These risks include:

• Fracture of the humerus (upper arm bone)
• Dislocation of the shoulder joint
• Nerve damage
• Incomplete release of the joint capsule

After these surgeries, patients need physical therapy. This helps keep and improve their shoulder movement. Recovery time varies, but most see big improvements in a few weeks to months.

Recovery and Rehabilitation

After treatment for frozen shoulder, the next step is recovery and rehabilitation. Post-operative care is key to a good outcome. It helps restore shoulder function and mobility. Patients will see their condition improve as they follow a structured rehabilitation program.

Physical therapy is a big part of getting better. A physical therapist will teach patients stretching exercises and activities to improve shoulder flexibility and strength. These exercises start off easy and get harder as the shoulder heals and pain goes away. It’s important to stick to the exercise plan for the best results.

Patients might also use pain management techniques like ice packs or over-the-counter pain meds. As the shoulder heals and gets more mobile, patients can start doing daily activities and light exercises again.

Recovering from frozen shoulder takes time and patience. How long it takes to get better varies. It depends on how bad the condition was, how well the patient follows the rehab plan, and how their body heals. Sometimes, it can take months to a year to fully recover.

It’s important to keep up with regular check-ups with the doctor or physical therapist. They can see how you’re doing, make changes to the rehab plan if needed, and help with any problems that come up. With hard work and gradual improvement, most people can get their shoulder back to normal and do their usual activities again.

Preventing Frozen Shoulder

Frozen shoulder can be very painful and limiting. But, there are ways to lower your risk. Making lifestyle changes and keeping your shoulders mobile are key.

Lifestyle Modifications

Living a healthy lifestyle can help prevent frozen shoulder. Eating well and staying active are important. Being overweight can put extra stress on your joints, including your shoulders.

Try to stay active with at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week. Also, do strength training twice a week.

Good posture is also vital. Bad posture can lead to muscle imbalances and strain on your shoulder. Be aware of your posture, even when sitting for long periods. Take breaks to stretch and move around.

Maintaining Shoulder Mobility

Regular stretching and exercises can keep your shoulders flexible. This helps prevent stiffness. Here are some simple exercises:

If you notice shoulder pain or stiffness, get help early. Early treatment can make a big difference. Don’t ignore pain or try to push through it, as this can cause more harm and a longer recovery.

Living with Frozen Shoulder (Adhesive Capsulitis)

Dealing with frozen shoulder can be tough, but there are ways to manage it. Pain management is key. You can use over-the-counter pain relievers like ibuprofen or acetaminophen. Heat or cold packs on the shoulder can also help.

Assistive devices make daily tasks easier when your shoulder is stiff. For example:

• Reacher grabbers for reaching high shelves
• Button hooks and zipper pulls for getting dressed
• Specially designed utensils with big handles for eating

Coping Strategies

Getting emotional support is also important. Joining a support group or talking to loved ones can help. Doing low-impact activities like walking or swimming can also improve your mood.

Long-term Outlook

The recovery time for frozen shoulder varies. Most people see improvement over months to a year. Here’s a general timeline for frozen shoulder stages:

With the right treatment and care, most people can fully recover from frozen shoulder. Some might have some stiffness or limited motion left. Working with a healthcare provider is key to the best outcome.

Alternative and Complementary Therapies

Some people find relief from frozen shoulder through alternative and complementary therapies. These methods, often based on Traditional Chinese Medicine or holistic practices, aim to ease pain and muscle tension. They also help promote relaxation. Even though more research is needed, many people have reported positive results from these therapies.

Acupuncture

Acupuncture is a key part of Traditional Chinese Medicine. It involves putting thin needles in specific spots on the body. This ancient practice believes that it can balance the body’s energy, or qi.

For those with frozen shoulder, acupuncture may help reduce inflammation and pain. It might also improve how well you can move your shoulder. Some studies show that using acupuncture with physical therapy can lead to better results.

Massage Therapy

Massage therapy is another way to help frozen shoulder. Massage therapists use different techniques to work on soft tissues. They target areas of tension and help improve circulation.

This can make muscles less stiff and help you relax. Massage is often most helpful during the “freezing” stage of frozen shoulder. It can help loosen tight muscles and improve shoulder function.

If you’re thinking about trying alternative or complementary therapies for frozen shoulder, talk to a healthcare provider first. They can help you safely add these therapies to your treatment plan. Many people find that combining traditional treatments with these approaches helps them feel better faster and get back to their daily activities sooner.

When to Seek Medical Attention

If you have ongoing pain and can’t move your shoulder well, see a doctor. Some stiffness is normal after an injury or when you’re not active. But, if the pain lasts, it might be frozen shoulder or another problem.

Getting medical help early is key to finding out what’s wrong. Your doctor will check your shoulder and might do tests to see how bad it is. This can stop the problem from getting worse and help you get better faster.

If your shoulder mobility gets worse or the pain is more, talk to your doctor. Quick action can help manage your symptoms and get you moving again. This way, you can live better and feel better too.