Frozen shoulder

Frozen shoulder, or adhesive capsulitis is a condition characterized by stiffness and pain in the shoulder joint. It typically develops gradually and worsens over time before eventually resolving, although this process can take several years. Here’s a detailed breakdown of the condition:

Stages of Frozen Shoulder

Frozen shoulder progresses through three distinct stages:

1. Freezing Stage:
   • Duration: This stage can last from six weeks to nine months.
   • Symptoms: Gradual onset of pain, increasing in severity, which limits shoulder movement. Pain is often worse at night and can disrupt sleep.
2. Frozen Stage:
   • Duration: This stage typically lasts from four to twelve months.
   • Symptoms: Pain may diminish, but the shoulder becomes stiffer. Range of motion is significantly reduced, making daily activities challenging.
3. Thawing Stage:
   • Duration: This stage can last from six months to two years.
   • Symptoms: Gradual improvement in the range of motion. The shoulder slowly returns to normal or near-normal function.

Causes and Risk Factors

The exact cause of frozen shoulder is not fully understood, but several factors can contribute to its development:

• Prolonged Immobilization: After surgery or an arm fracture.
• Systemic Conditions: Diabetes, thyroid disorders, cardiovascular disease, and Parkinson’s disease increase the risk.
• Age and Gender: Most common in people aged 40 to 60 and more prevalent in women.
• Other Factors: Shoulder injuries, surgeries, and certain systemic conditions.

Diagnosis

Diagnosis of frozen shoulder typically involves:

• Medical History Review: Assessing symptoms and any underlying conditions.
• Physical Examination: Evaluating shoulder range of motion and pain response.
• Imaging Tests: X-rays or MRI to rule out other conditions like arthritis or rotator cuff tears.

Treatment Options

Treatment aims to alleviate pain and restore shoulder movement. Approaches include:

1. Non-Surgical Treatments:
   • Physical Activity: Stretching and strengthening exercises to improve mobility.
   • Medications: Over-the-counter pain relievers like ibuprofen or acetaminophen.
   • Steroid Injections: Corticosteroid injections to reduce inflammation and pain.
   • Heat and Cold Therapy: Applying heat to relax muscles and cold to reduce pain.
2. Surgical Treatments:
   • Shoulder Manipulation: Under anesthesia, the shoulder is moved to break up scar tissue.
   • Arthroscopic Surgery: Minimally invasive surgery to cut through the tight capsule.

Prognosis

Frozen shoulder can resolve on its own, but full recovery can take several years. Early intervention with physical therapy and appropriate treatments can significantly improve outcomes.

Prevention

While it’s not always possible to prevent frozen shoulder, certain measures can reduce the risk:

• Maintain Mobility: Regular shoulder exercises, especially after an injury or surgery.
• Manage Underlying Conditions: Proper control of diabetes and other systemic diseases.
• Avoid Prolonged Immobilization: Keeping the shoulder active even after minor injuries.

Understanding these aspects of frozen shoulder can help in managing and mitigating its impact.