what is a frozen shoulder?
Frozen shoulder, or adhesive capsulitisadhesive capsulitisSelf-limiting condition resulting from any inflammatory process about the shoulder in which capsular scar tiss..., is a condition that creates painpainAn unpleasant sensation associated with actual or potential tissue damage, and mediated by specific nerve fibe... and stiffness in the shoulder jointjointThe junction or articulation of two or more bones that permits varying degrees of motion between the bones., severely limiting the patient‘s ability to move the shoulder normally. When this happens, the shoulder feels like it is "frozen" in place. Difficulty raising the arm in front of the torso or putting the hand behind the head or back are typical.
Frozen shoulder occurs when there is a problem with the capsule that surrounds the shoulder jointjointThe junction between the ends of two adjacent bones.. Sometimes the capsule thickens or decreases in size, restricting the joint.
The result is a lack of mobility and severe pain.
what causes frozen shoulder? who is at risk?
Frozen shoulder may be the result of inflammationinflammationA local response to injury due to a physical reaction (such as abrasion), or to chemical or biological agents,... after a shoulder injury or shoulder surgerysurgeryThe branch of medicine concerned with the treatment of disease, injury, and deformity by operation or manipula.... In most cases, however, frozen shoulder develops for no apparent reason in individuals over age 40. It's also more likely to appear in women. Those with diabetesdiabetesA disease where the body does not produce or use insulin correctly (This leads to: hyperglycemia - an increase..., rheumatoid arthritisrheumatoid arthritisGeneralized inflammatory joint disease., heart or lung disease, strokestrokeA disability caused by injury to the brain regardless of the cause. Most stroke are caused by loss of blood fl..., or thyroid problems also are at higher risk for frozen shoulder.
what are the symptoms of frozen shoulder?
The pain of frozen shoulder is accompanied by stiffness or loss of motion. This may cause a severe restriction of movement. The symptoms usually develop gradually over weeks or months. Patients may find that:
- Pain is most severe during the early stages of the condition
- Pain is usually worse at night
- As pain decreases, stiffness and immobility increase
- Pain may travel from the shoulder down to the elbow
- A "thawing phase" occurs, during which time the condition may improve on its own
how is frozen shoulder diagnosed and treated?
Doctors usually can diagnose frozen shoulder after a physical examination and medical history. Since pain is a common symptom of most shoulder problems, other diagnoses including tendinitistendinitisAny injury that produces an inflammatory response within the tendon substance., bursitis or rotator cuffrotator cuffThe rotator cuff is made up of four muscles and their tendons. These combine to form a "cuff" over the head of... tears will need to be ruled out.
Treatment options will focus on restoring mobility and reducing pain. They may include pain medications and physical therapyphysical therapyThe treatment consisting of exercising specific parts of the body such as the legs, arms, hands or neck, in an... to learn simple stretching exercises. Patients also may benefit from TENS stimulation to help reduce pain.
In some cases there may be ongoing limitations to motion, but patients should be able to perform most of their daily activities. Surgery is rarely necessary, but may be beneficial if mobility doesn't sufficiently improve.
what can patients expect long term?
Frozen shoulder almost always resolves by itself. However, it may take many months or even up to three years for the pain and stiffness to go away completely. NSAIDsNSAIDsA nonsteroidal anti-inflammatory drug such as ibuprofen. and heat applied to the affected area may help while the shoulder heals. The doctor will advise the patient on follow-up visits.
While recovering, patients may want to avoid shoulder motions or positions that are painful. This may include motions that raise the arm to the side or rotate it outward such as reaching overhead or behind them, opening a heavy door and handling a steering wheel. Experts do not suggest "working through the pain" when dealing with a frozen shoulder—instead contact a doctor for advice.