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Frozen Shoulder: Causes, Diagnosis, and Treatment

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Frozen Shoulder: Causes, Diagnosis, and Treatment

Orthopaedics & Joint Replacement | Posted on 05/02/2020 by RBH

Frozen shoulder also medically referred to as adhesive capsulitis, is a condition of the shoulder that affects the range of motion. The condition occurs when tissue in the joint of the shoulder becomes thicker and tighter, leading to the development of scar tissues over time. This causes a lack of space for the shoulder joint restricting its free movement.

Causes of a Frozen Shoulder

A frozen shoulder is a very common condition that reduces mobility. Typically the shoulder is made of three bones including the shoulder blade, collarbone, and upper arm bone. It also has a ball-and-socket joint, surrounded by connective tissue, and movement of which is enabled by synovial fluid. A frozen shoulder occurs when the normal movement of the shoulder joint is restricted due to the development of scar tissues which leads to the thickening and tightening of the joint capsule.

That said, the exact cause of a frozen shoulder cannot always be determined. However, hormonal imbalance, diabetes, weak immune system, etc. can cause joint inflammation which could lead to a frozen shoulder. An injury, trauma, inactivity, wrong posture, illness or recent surgery can also make a person more prone to inflammation and frozen shoulder issues.

Risks of a Frozen Shoulder

Even though the exact causes in most cases cannot be determined, yet some people are at more risk of experiencing a frozen shoulder as compared to others. Some risk factors include:

  • Middle-age (40 years and above)
  • Women
  • Diabetes
  • Thyroid disorders
  • Stiffness due to shoulder sling or brace
  • A long period of inactivity due to an injury or surgery
  • Cardiovascular diseases
  • Parkinson’s disease
  • Stroke

Diagnosis of a Frozen Shoulder

Since a frozen shoulder is detected upon pain, the doctor will diagnose the condition based on risk factors, symptoms, signs, and a physical exam more attentively focused on the shoulders and arms. The severity of the condition can be determined by pressing and moving certain parts of the arms and shoulders. Though in problems in the structure of the shoulder can only be diagnosed through imaging tests – X-ray or an MRI.

Treatment of a Frozen Shoulder

Not all patients who suffer from a frozen shoulder realize it unless it causes severe mobility restrictions. In many cases, they tend to live with restricted mobility without taking any treatment. An untreated frozen shoulder can last as long as three years, thus, treatment becomes a necessity. Some treatment options include:

Physical Therapy: This is the most common form of treating a frozen shoulder. In this, the aim is to restore mobility and reduce pain by stretching the shoulder joint and regaining strength. However, the results can take a few weeks to almost nine months, depending on the severity of the condition. For patients who do not feel any improvement even after physical therapy and recommended home exercises, another course of medical treatment may be sought.

Medications: An alternative form of treatment of frozen shoulder is medication to reduce joint inflammation and pain. In some cases, a steroid injection will also help.

Home Exercises and Care: Certain recommended home exercises can help improve a frozen shoulder. Moreover, ice therapy for about 15 minutes every day is expected to impact the condition positively. Though, all exercises must be performed either under supervision or on recommendation from the physical therapist.

Surgery: In cases, where all other forms of treatment fail to restore mobility or reduce the pain of the shoulder joint, surgery may opt for treatment. In a typical surgery, the surgeon will break up the adhesions and manipulate the shoulder to regain full motion of the shoulder. On the other hand, in an arthroscopic surgical treatment,the medical professional makes a small incision in the affected shoulder and uses an arthroscope to remove or release the scar tissue and mobilize the shoulder effectively. In the case of patients who have a frozen shoulder caused due to an injury or trauma, surgery is usually preferred over other forms of treatment. Also, it is essential to get the surgery done within a few weeks of the injury. In all cases, the patient will be advised to follow up with postoperative physical therapy to strengthen the shoulder joints and to revive the full motion.

Overall, patients can easily recover from a frozen shoulder with effective treatment. In many cases, a combined treatment approach can be followed to speed up the recovery. That said, it is possible to prevent the condition if a patient adopts measures such as effective management of blood glucose levels, regular exercises for strengthening, cautious shoulder lifting, and other exercises that can cause injury, etc. It is not advisable to leave a frozen shoulder untreated since the pain and restricted mobility could worsen and last for almost 2 years.