Frozen shoulder is a condition characterized by stiffness and pain in the shoulder joint which is medically known as adhesive capsulitis. The shoulder is made of bones, ligaments and tendons encased in a capsule of connected tissues. The capsule thickens and tightens around the shoulder and restricts your movement and this can be very painful.
Structure of the Shoulder
The shoulder is made up of a connection of three bones- the arm bone (the humerus), the shoulder blade called the scapula and the clavicle (the collar bone). They meet together around the shoulder and you have articulation or movement around each other. There are four rotator cuff muscles that keep the shoulder stable; two at the back, one at the top and one in front of the shoulder blade. They all keep the shoulder together. The shoulder is a very mobile joint; it can almost go around in a circle therefore it is more prone to injury.
Sign and Symptoms
With frozen shoulder, you have pain in almost every movement, in fact, you are unable to lift your shoulder. This happens after your shoulder has been immobilized meaning you’re not moving your arm for a period of time. This is seen in individuals who have had Rotator Cuff Injury or a broken arm, a broken collar bone, after a stroke or even after mastectomy (breast surgery). Essentially what happens within the shoulder joint is the injury/condition limits movement around the shoulder and it seizes up. The capsule becomes so rigid that it inhibits movement. This can be very painful and it limits your function.
Stages of Frozen Shoulder
This is the earlier part of the frozen shoulder pathway characterized by high pain intensity with movement.
In the frozen stage, it is more difficult to move the shoulder but the pain is not as intense as the freezing stage.
If the condition is detected during the freezing stage, a physiatrist or musculoskeletal doctor such as an Orthopaedic surgeon can offer treatment that will decrease the pain and increase mobility.
It’s interesting to note that frozen shoulder is self-limiting meaning that the condition can resolve on its own after 12 – 18 months, introducing the thawing stage. In this stage, the pain returns but it eventually goes away, resolving the condition.
The older you become, the more susceptible you are to frozen shoulder. Specifically, people over 40 years old and women are more prone to frozen shoulder. Studies have shown that reduced mobility of the arm predisposes individuals to frozen shoulder. There are systemic diseases that may influence frozen shoulder such as Diabetes, Thyroid problems, cardiovascular diseases and even Parkinson’s disease.
Doctors will recommend over-the-counter, anti-inflammatory medication such as ibuprofen and aspirin that will reduce the pain and inflammation.
The therapist will help to increase the range of motion by recommending appropriate shoulder exercise.
The musculoskeletal doctor such as physiatrist, can inject steroid injection. During an examination for frozen shoulder, the physiatrist will inject the shoulder with numbing medication similar to what you receive before a dental procedure. This numbing medication will reduce the pain allowing the physiatrist to manipulate and move the shoulder increasing mobility in the joint.
If the pain is unresolved, you may need to see an orthopaedic surgeon who may treat you with arthroscopic surgery (a small camera) to identify the scar tissues or adhesions (looking similar like cobwebs).
It is important to visit your general practitioner or primary medical doctor to identify the cause of your shoulder pain so that the most appropriate treatment can be recommended.