Frozen Shoulder (Adhesive Capsulitis)
What is a Frozen Shoulder (Adhesive Capsulitis)?
A frozen shoulder is simply that, a shoulder that is no longer allowing movement. This is a painful condition that is caused by the build up of scar tissue or thickening of the joint capsule in the shoulder. This condition is more common in women than in men and chances of it increase after the age of forty. A frozen shoulder can happen with extended inactivity such as having the arm immobilized after a fracture, a shoulder surgery, or recovering from a stroke. Risk factors that increase the chance of having a frozen shoulder are diabetes, thyroid disorders, heart disease, tuberculosis, or Parkinson’s disease. A frozen shoulder can start off slowly with progressive stiffening and pain in the joint until the joint freezes. The shoulder will stay frozen for a while without intervention and the pain will subside. Over time frozen shoulders can resolve on their own. It is usually preferable to see a specialist for a frozen shoulder to gain back mobility and reduce the pain in a more timely fashion.
Treatment for a Frozen Shoulder
Conservative Treatment for a Frozen Shoulder
Conservative treatment for a frozen shoulder is going to revolve around pain relief and gaining mobility back to the shoulder in a more advanced timeframe than healing on its own. NSAIDs, over the counter medicines, such as Advil, Aleve, or Tylenol, can be used to help control some of the pain associated with a frozen shoulder. NSAIDs also have an anti-inflammatory property than can be useful, but NSAIDs are associated with gastric ulcers with extended use, so it may be better to see a doctor if you are going to need them for more than what the label suggests. Shoulder specialists can use a mixture of anesthetic and corticosteroids to inject into the joint capsule, subacromial injection, to relieve pain and reduce some of the pressure inside of the joint. Physical Therapy can also be utilized to try to gain back some range of motion. A heating element can be used as well to help try to loosen the tissues and reduce pain.
In patients with Frozen shoulder, it typically develops slowly in three stages. Each stage may last several months.
- Freezing stage. Any movement of a patients shoulder causes pain, and the shoulder’s range of motion starts to become limited.
- Frozen stage. Pain may diminish during this stage. However, as the shoulder gets stiffer, patients have more difficulty using it.
- Thawing stage. The range of motion in the shoulder slowly improves.
For some people, the pain worsens at night, leading to worse sleep.
One of the most common causes of frozen shoulder is the immobility that may result during recovery from a shoulder injury, broken arm or a stroke. If you’ve had an injury that makes it difficult to move your shoulder, Contact Us about exercises you can do to maintain the range of motion in your shoulder joint.
Surgical Intervention for a Frozen Shoulder
If conservative treatments fail to achieve success surgical interventions can be considered such as joint distension or shoulder arthroscopy for capsular release. Joint distension would involve injecting sterile liquid into the joint to stretch the capsule and allow for the joint to move more freely. In joint arthroscopy the goal would be to remove scar tissue that is impeding movement as well as freeing up overtightened ligaments. Physical Therapy would be utilized during recovery to ensure range of motion and returning to full strength.
