FROZEN SHOULDER

Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move. The shoulder capsule thickens and becomes stiff and tight. Thick bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint. The hallmark signs of this condition are severe pain and being unable to move your shoulder -- either on your own or with the help of someone else. It develops in three stages:

STAGE 1: FREEZING

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.

STAGE 2: FROZEN

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.

STAGE 3: THAWING

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.

CAUSES

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

Diabetes:

Frozen shoulder occurs much more often in people with diabetes.

Other diseases:

Some additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease.

Immobilization:

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

TREATMENT

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.

Physical therapy:

Specific exercises will help 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.

SURGICAL TREATMENT:

Surgery for frozen shoulder is typically offered during "Stage 2: Frozen." The goal of surgery is to stretch and release the stiffened joint capsule. The most common methods include manipulation under anaesthesia and shoulder arthroscopy.