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Frozen shoulder

What is Frozen Shoulder

Have you ever experienced excruciating shoulder pain and noticed a sudden limitation in movement? If so, you might be dealing with a condition known as frozen shoulder. This enigmatic ailment affects countless individuals and can significantly impact daily activities and quality of life.

Frozen shoulder, also referred to as adhesive capsulitis, is a condition characterized by pain, stiffness, and restricted range of motion in the shoulder joint. It typically develops gradually and progresses through three distinct phases: freezing, frozen, and thawing.

FROZEN SHOULDER (ADHESIVE CAPSULITIS)

  • In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue —called adhesions — develop. In many cases, there is less synovial fluid in the joint. Also, at IROSM, we are experts in treating frozen shoulder.
  • The hallmark sign of this condition is being unable to move your shoulder – either on your own or with the help of someone else. It develops in three stages:
    • Freezing. First lf all, in the “freezing” stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
    • Frozen : Secondarily, painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.
    • Thawing: Lastly, shoulder motion slowly improves during the “thawing” stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

REAL STORIES

What causes a frozen shoulder?

The causes of frozen shoulder are not fully understood. Also, there is no clear connection to arm dominance or occupation. Furthermore,  a few factors may put you more at risk for developing frozen shoulder.

Frozen shoulder occurs much more often in people with diabetes, affecting 10% to 20% of these individuals. In addition, the reason for this is not known.

Some additional medical problems associated with frozen shoulder include thyroid problems, Parkinson’s disease, and cardiac disease. Lastly, emotional stressors can also trigger the beginning of frozen shoulder.

Frozen shoulder can develop after a shoulder has been immobilized for a period of time. This can be  due to surgery, a fracture, or other injury. In addition, having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent frozen shoulder.

What are the symptoms of a frozen shoulder?

Pain from frozen shoulder is usually dull or aching. It is typically worse early in the course of the disease and when you move your arm. The pain is usually located over the outer shoulder area and sometimes the upper arm.

Imaging Tests

Other tests that may help your doctor rule out other causes of stiffness and pain include:

X-rays. Dense structures, such as bone, show up clearly on x-rays. X-rays may show other problems in your shoulder, such as arthritis.

Magnetic resonance imaging (MRI) and ultrasound. These studies can create better images of problems with soft tissues, such as a torn rotator cuff.

 

stem cell for rotator cuff tear

How is a frozen shoulder diagnosed?

Frozen shoulder generally gets better over time, although it may take up to 3 years.

The focus of treatment is to control pain and restore motion and strength through physical therapy.

Nonsurgical Treatment

More than 90% of patients improve with relatively simple treatments to control pain and restore motion.

Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and swelling.

Steroid injections. Cortisone is a powerful anti-inflammatory medicine that is injected directly into your shoulder joint.

Physical therapy. Specific exercises will help restore motion. These may be under the supervision of a physical therapist or via a home program. Therapy includes stretching or range of motion exercises for the shoulder. Sometimes heat is used to help loosen the shoulder up before the stretching exercises. Below are examples of some of the exercises that might be recommended.

External rotation — passive stretch.

Stand in a doorway and bend your affected arm 90 degrees to reach the doorjamb. Keep your hand in place and rotate your body as shown in the illustration. Hold for 30 seconds. Relax and repeat.

Forward flexion — supine position.

Lie on your back with your legs straight. Use your unaffected arm to lift your affected arm overhead until you feel a gentle stretch. Hold for 15 seconds and slowly lower to start position. Relax and repeat.

Crossover arm stretch.

Gently pull one arm across your chest just below your chin as far as possible without causing pain. Hold for 30 seconds. Relax and repeat.

Surgical Treatment

If your symptoms are not relieved by therapy and anti-inflammatory medicines, you and your doctor may discuss surgery. It is important to talk with your doctor about your potential for recovery continuing with simple treatments, and the risks involved with surgery.

The goal of surgery for adhesive capsulitis is to stretch and release the stiffened joint capsule. The most common methods include manipulation under anesthesia and shoulder arthroscopy.

Manipulation under anesthesia.

During this procedure, you are put to sleep. Your doctor will force your shoulder to move which causes the capsule and scar tissue to stretch or tear. This releases the tightening and increases range of motion.

Shoulder arthroscopy.

In this procedure, your doctor will cut through tight portions of the joint capsule. This is done using pencil-sized instruments inserted through small incisions around your shoulder.

In many cases, manipulation and arthroscopy are used in combination to obtain maximum results. Most patients have very good outcomes with these procedures.

Ultrasound Guided Release

Minimally Invasive Procedure where Dr. Jorge A. Gonzalez will use high resolution ultrasound waves to see inside the shoulder and break the scar tissue with a series of injections.  The Ultrasound guided procedures can break away the scar tissue and restore range and motion. 

The procedure usually takes 10-15 minutes. In most patients, improvement happens rapidly. 

Frozen Shoulder Release in the News

Minimally Invasive Frozen Shoulder Release.

Frozen Shoulder FAQ

 

If you’re experiencing shoulder pain and stiffness, you may have heard about frozen shoulder. In this FAQ guide, we’ll address common questions related to frozen shoulder, its treatments, and exercises that can help alleviate symptoms.

What is frozen shoulder? FS also known as adhesive capsulitis, is a condition characterized by pain and stiffness in the shoulder joint. It occurs when the connective tissues surrounding the shoulder joint become thickened and tight.

What are the causes of frozen shoulder? The exact cause of is not fully understood. However, certain factors can increase the risk, such as diabetes, thyroid disorders, and previous shoulder injuries. It often develops gradually and can be divided into three stages: freezing, frozen, and thawing.

What are the treatment options for frozen shoulder? There are several  treatments available, depending on the severity of the condition. Non-surgical approaches, including physical therapy, stretching exercises, and medications, are often the first line of treatment. These help improve mobility, reduce pain, and restore shoulder function.

Are there specific exercises for frozen shoulder? Yes, there are  shoulder exercises that can help improve range of motion and flexibility. Gentle stretching exercises, such as pendulum swings and cross-body stretches, can be beneficial. However, it’s important to consult with a healthcare professional before attempting any exercises to ensure they are suitable for your condition.

What are minimally invasive treatments for frozen shoulder? In cases where conservative measures do not provide sufficient relief, minimally invasive treatments may be considered. These include corticosteroid injections, which help reduce inflammation and pain, and minimally invasive treatments such as hydrodilatation. Hydrodilatation involves injecting sterile fluid into the shoulder joint to stretch the capsule and improve mobility.

In conclusion

 FS can be a painful and limiting condition. However, with proper frozen shoulder treatment, including exercises and minimally invasive interventions, relief is possible. If you’re experiencing symptoms of adhesive capsulitis it’s important to consult with a healthcare professional. Our board-certified sports medicine physician at the Institute of Regenerative Orthopedics & Sports Medicine (IROSM) are experts in treating shoulder pain. We can provide an accurate diagnosis and develop an individualized treatment plan to help you regain shoulder function and improve your quality of life.