WHAT IS FROZEN SHOULDER–
Frozen Shoulder which is also known as adhesive capsulitis, is a common situation characterized by chronic pain and stiffness in the joints of shoulder. It is a condition in which the articular shoulder capsule which means a sac of ligaments surrounding the joint stiffens and swells. The shoulder moves very hardly.
In this condition the shoulder capsule becomes tight and thickens. Adhesions, the stiff bands of tissue develops. In most of the cases, there is less synovial fluid involved in the joint.
The main characteristic of such condition is to move your shoulder neither on your own nor with the help of someone else. It happens in three stages:
The first stage is “Freezing” stage, the pain slowly increases more and more. When it becomes worse, your shoulder loses range of motion. This stage lasts from 6 weeks to 9 months.
The second stage is “Frozen” stage, here the stiffness remains the same and other painful symptom s actually improves. Daily activities becomes difficult during 4 to 6 months.
The third stage is “Thawing” stage, here the shoulder motion improves. It almost recovers completely or near to it strength and motion takes from 6 months to 2 years.
The smooth tissues of the shoulder capsule becomes inflamed, thick and stiff, in this frozen shoulder.
Frozen shoulder is a most common pain in shoulder. It sometimes leads into the upper arm and shoulder blade pain.
Frozen shoulder is a situation which mostly occurs in people between 40 and 60 years of age. Most commonly it occurs in women more than men. It occurs in almost 2% to 5% of the general population.
SYMPTOMS OF FROZEN SHOULDER-
The foremost symptom of frozen shoulder is a persistently painful and stiff shoulder joint. The symptoms and signs of the frozen shoulder increases gradually. Usually the sign and symptoms worsen gradually and resolve within a two –year period.
- The pain increases and becomes worse during night at shoulder joint.
- Painful joint range of motion (JROM).
- Patient becomes unable to reach above shoulder height.
- It becomes painful to sleep on your side.
- Tenderness remains presents at the shoulder joint line.
- Sometimes, mostly at night tingling sensation can be felt by patients at night.
- Swelling can be seen at the shoulder line.
- In second stage, patient can feel radiating pain from shoulder to elbow.
- Also, the stiffness can often increase and becomes worse.
- In third stage, patients sometimes also complaints about having a feeling of numbness over little finger and ring finger.
CAUSES OF FROZEN SHOULDER-
The cause of the frozen shoulder is not exactly understood, also in some cases it is unidentifiable. Still there are a number of other reasons responsible for increasing your risk of developing frozen shoulder. Some of them are given below here:
- Diabetes can be a reason to develop frozen shoulder. It is a greater risk of developing a frozen shoulder.
- Due to having stroke.
- Due to heart disease ( Cardiovascular disease).
- Also when thyroid remains underactive or overactive.
- Due to arm fracture or recent surgery which fails to recover completely often cause the shoulder capsule to stiffen.
- Sometimes due to being over 40 years of age and mostly 70% of people with frozen shoulder are women.
- Also when body remains immobilize for long time the shoulder can frozen up.
- Due to being suffered from low blood pressure.
- Due to Arthritis disease.
- Also, when people is suffering from Rotater Cuff Injury. It is when the rotater cuff is a group of muscles that control shoulders.
- Bursitis, it is when inflammation of a bursa, typically a kind of shoulder joint pain.
- Capsulitis disease.
- Cervical disk disease of the neck.
- Due to Parkinson’s disease.
DIAGNOSIS AND TESTS OF FROZEN SHOULDER-
The doctors will diagnose frozen shoulder most likely based on symptoms and signs and a physical exam by paying close attention to the shoulders and arms. The condition of the frozen shoulder is diagnosed by a basic test in which a doctor presses and moves certain parts of the shoulder and arms.
- PHYSICAL DIAGNOSIS:-
- Range of motion: The normal range of motion is 0 degree to 180 degree. Due to stiffness or pain it becomes unable to move till 180 degree.
- On palpation: Doctors presses the shoulder joint to verify the tenderness and swelling.
- IMAGINARY DIAGNOSIS:-
- X-Ray: An X-ray is a kind of electromagnetic radiation that can penetrate most solid objects to create pictures of an object’s interior. Sometimes we can find bony spur in the arthritis patient, which affect the normal shape of GlenoHumoral Joint ( shoulder joint).
- MRI: MRI, Magnetic Resonance Imaging uses magnetic signals to create image “slices” of the soft tissues inside the body of humans. Also any injury to muscule ligaments, tenden, and capsule can be easily observed.
HOME TREATMENT FOR FROZEN SHOULDER-
There are certain treatments which can be used by the patients for temporary relief:-
- Hot water bags can be used to reduce pain and swelling.
- Cold compression packs can be to provide relief in pain at shoulder joint line.
- In excess pain, patient can also take Painkillers. It may reduce inflammation of the shoulder in addition to alleviating mild pain. Make sure to review options with your doctor, as not all painkillers are suitable for every patient.
- Patient should try to keep the shoulder in active position, so that it can be prevent from being immobilize.
PHYSIOTHERAPY TREATMENT FOR FROZEN SHOULDER-
The goal of physiotherapy treatment for frozen shoulder is to alleviate the pain and preserve flexibility and mobility in the shoulder. As symptoms tend to remain for several years, recovery may be slow:-
- EXERCISES AND STRECTHS – There are some exercises which can be done to rehab the frozen shoulder:-
- Shoulder Pendulum
- Standing Flexion Cane Exercise
- Extension Cane Exercise
- External Rotation Cane Exercise
- Internal Rotation Cane Exercise
- Shoulder Shrug Cane Exercise
- Internal Rotation- Standing
- Internal Rotation- Lying On Side
- Advanced Anterior Shoulder Stretch
- Shoulder Blade Settings
- Over Head Raise
- Neck Stretches
- Shoulder Rolls
- CORTICOSTEROID INJECTIONS- A kind of steroid hormone injection that reduces pain and swelling. It should used only in the “painful stage” as they could cause damage to the shoulder if repeated.
- TENS- Transcutaneous Electrical Nerve Stimulation is a machine which numbs the nerve, which ends in the spinal cord that control pain and provides small pulses of electricity from the TENS machine.