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  • Writer's pictureDr. Darshil Shah

Frozen Shoulder [Adhesive Capsulitis]

Adhesive capsulitis, also called frozen shoulder, causes the shoulder to become stiff and painful to move. This condition happens when there is inflammation of the tendons and ligaments that surround the shoulder joint (shoulder capsule).


Common signs and symptoms


  • Pain around the shoulder joint

  • Stiffness of the shoulder

  • Inability to actively and passively lift arm

  • Night pain


Causes


This condition may be caused by:

  • An injury to your shoulder joint.

  • Heart surgery

  • Long-standing conditions, such as:

    • Diabetes.

    • Thyroid problems.

    • Heart disease.

    • Stroke.

    • Rheumatoid arthritis.

    • Lung disease.


In some cases, the cause is not known.



Expected outcome


  • Frozen shoulder is usually a self-limiting condition which resolves on its own over a period of 9 months to 1 year

  • The condition progresses through three stages:

    • Painful shoulder

    • Stiff shoulder

    • Gradual resolution of stiffness and pain



General treatment considerations


Initial treatment consists of medications and ice to relieve pain, gentle shoulder movements. These can all be carried out at home in acute cases. Chronic cases often require referral to a physical therapist for further treatment.


Heat and cold


Cold is used to relieve pain and reduce inflammation. It should be applied for 10 to 15 minutes every 2 to 3 hours and immediately after any activity that aggravates your symptoms. Use ice packs or an ice massage.


Heat may be used before performing stretching and strengthening activities prescribed by your physician, physical therapist.


When to call your Orthopaedic Surgeon?


If you're suffering from any of the above mentioned symptoms, kindly visit your orthopaedic surgeon or consult with Dr. Shah to get a treatment plan taking into consideration your activity level/age etc. Kindly refrain from visiting a bone setter or self-treating the injury, this may lead to worsening of symptoms and cause further damage.


Treatment


This condition may be treated with:

  • Treatment of the underlying cause or condition.

  • Medicine may be given to relieve pain, inflammation, or muscle spasms.

  • Steroid injections into the shoulder joint.

  • Physical therapy. This involves performing exercises to get the shoulder moving again.

  • Shoulder manipulation. This is a procedure to move the shoulder through various ranges. It is done after you are given a medicine to make you fall asleep (general anesthetic). The joint may also be injected with salt water at high pressure to break down scarring.

  • Surgery. This may be done in severe cases when other treatments have failed.


Exercises


Here are 3 good exercises you can try:

  • Climbing the wall : Put your hand flat on a wall in front of you. Use your fingers to "climb" up the wall (like a "spider"). As you move your fingers up little by little, stop and hold your hand in place for 30 seconds every few inches. Move your fingers up the wall as high as you can reach. Keep trying to go higher.

  • Codman exercise : Sit sideways in a straight chair. Rest your armpit on the back of the chair. Now swing your arm slowly in circles. Make little circles at first and then make bigger circles. Make the circles in both directions.

  • Reaching : Put things you use every day (shoes, coffee cup, toothbrush) on a high shelf. This way you have to reach up for things more often. The reaching is a good stretch for your shoulder.

Do the exercises once or twice a day even after your shoulder gets better. Don't forget to exercise your healthy shoulder too, so that you can maintain the movement that you have in that shoulder.

Many people who have adhesive capsulitis get full use of their shoulder back. Others may always have a little stiffness and pain in that shoulder.


Although most people recover completely from adhesive capsulitis, some may not regain full shoulder movement.








The above article is written to provide general information to the common public. Please consult your orthopaedic surgeon before beginning any sort of treatment. Do not attempt to self-medicate as this may lead to undesirable side effects.

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