Frozen Shoulder

Overview

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint. It typically develops slowly in three stages: the freezing stage, the frozen stage, and the thawing stage. The freezing stage involves pain and limited shoulder movement, while the frozen stage may see a reduction in pain but increased stiffness. The thawing stage involves improvement in shoulder mobility. Frozen shoulder can occur in people who have kept their shoulder immobile for a prolonged period, such as after surgery or a broken arm. Certain factors, such as age, sex, immobility, and certain systemic diseases like diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease, and Parkinson's disease, may increase the risk of developing frozen shoulder. Treatment for frozen shoulder usually involves range-of-motion exercises, but in some cases, corticosteroids, numbing medications, or arthroscopic surgery may be necessary.

Understanding the disease

Symptoms

The symptoms of frozen shoulder typically develop slowly in three stages. The symptoms include:

1. Freezing stage: Pain occurs with any movement of the shoulder, and the shoulder's ability to move becomes limited. This stage lasts from 2 to 9 months.
2. Frozen stage: Pain might lessen during this stage, but the shoulder becomes stiffer, and using it becomes more difficult. This stage lasts from 4 to 12 months.
3. Thawing stage: The shoulder's ability to move begins to improve. This stage lasts from 5 to 24 months. In some cases, pain may worsen at night, disrupting sleep. The exact causes of frozen shoulder are not clear, but it occurs when the connective tissue capsule around the shoulder joint thickens and tightens, restricting movement. Risk factors include age, sex, immobility or reduced mobility, and certain systemic diseases.

Risk Factors

Risk factors for developing frozen shoulder include:

1. Age and sex: People 40 and older, particularly women, are more likely to have frozen shoulder.
2. Immobility or reduced mobility: Individuals who have had to keep their shoulder relatively still for an extended period due to factors such as rotator cuff injury, broken arm, stroke, recovery from surgery, or systemic diseases like diabetes, overactive thyroid (hyperthyroidism), underactive thyroid (hypothyroidism), cardiovascular disease, or Parkinson's disease are at higher risk.

Development

Frozen shoulder typically develops slowly in three stages: the freezing stage, the frozen stage, and the thawing stage. During the freezing stage, any movement of the shoulder causes pain, and the shoulder's

Assessment and Diagnosis

Triage

You should consider seeing a doctor if you suspect you have frozen shoulder, especially if you experience severe pain, difficulty moving your shoulder, or if your symptoms have not improved after several months of home treatment. Additionally, if you have underlying medical conditions like diabetes, an overactive or underactive thyroid, cardiovascular disease, or Parkinson's disease, consulting a doctor is advisable to ensure proper diagnosis and management of your condition.

Diagnosis

Frozen shoulder can usually be diagnosed based on signs and symptoms alone. A health care provider may perform a physical exam to check for pain and assess the active and passive range of motion in the affected shoulder. Imaging tests, such as X-rays, ultrasound, or MRI, may be used to rule out other potential issues.

Management and Treatment

Prevention

While there is no surefire way to prevent frozen shoulder entirely, taking steps to maintain shoulder mobility and prevent long periods of immobility can help reduce the risk. Some ways to prevent or minimize the risk of developing frozen shoulder include:

1. Maintaining regular shoulder movements: If you have had a shoulder injury, broken arm, or undergone surgery, make sure to follow your healthcare provider's recommendations for exercises and physical therapy to maintain movement in the shoulder.
2. Addressing underlying health conditions: If you have underlying health conditions such as diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease, or Parkinson's disease, work with your healthcare provider to manage these conditions effectively.
3. Staying active: Engaging in regular physical activities and exercises can help maintain joint mobility and flexibility, reducing the risk of developing frozen shoulder.
4. Practicing proper body mechanics: Ensure you use proper posture and body mechanics when performing daily tasks, especially those that involve the shoulders. Remember that the risk of frozen shoulder can be higher in individuals who experience prolonged immobility or reduced shoulder movement. Taking proactive steps to maintain shoulder flexibility and mobility can help lower the risk of developing frozen shoulder.

Home Remedies

It is best to consult a healthcare professional for appropriate treatment recommendations.

Treatment

Treatment for frozen shoulder involves range-of-motion exercises. Sometimes treatment involves corticosteroids and numbing medications injected into the joint. Rarely, arthroscopic surgery is needed to loosen the joint capsule so that it can move more freely.

Preparing for medical consultation

To prepare for an appointment for frozen shoulder, you can take the following steps:

1. Write down your symptoms: Before your appointment, make a list of your symptoms, including the duration, severity, and any factors that worsen or relieve the pain.
2. Note any recent injuries or events: Think about any recent injuries, surgeries, or events that may have contributed to the development of your frozen shoulder.
3. Gather medical history: Prepare a list of your medical history, including any existing conditions, previous surgeries, and current medications.
4. Make a list of questions: Prepare a list of questions to ask your healthcare provider during the appointment. This may include inquiries about diagnosis, treatment options, and any potential side effects.
5. Wear loose clothing: Wear loose and comfortable clothing to the appointment to allow for easy movement and access to your shoulder.
6. Be prepared for a physical exam: Expect the healthcare provider to perform a physical exam during the appointment, which may involve checking your range of motion and assessing your pain levels. By being prepared and gathering all relevant information, you can make the most of your appointment and receive the best possible care for your frozen shoulder.