Understanding Frozen Shoulder: Causes, symptoms and treatment options

Shoulder is one of the important parts of the human body which supports a wide range of motion. The shoulder works with the rest of the upper body to stabilize and control arm movements. A healthy shoulder allows pain-free movement and ease of performing daily activities. Frozen shoulder also known as adhesive capsulitis can significantly impact a person’s life as it causes pain, stiffness and limits the motion of the shoulder joint. In this blog, we’ll discuss the causes, symptoms and treatment options for frozen shoulder but before we get into it, what actually is a frozen shoulder?

Frozen shoulder:

Frozen shoulder or adhesive capsulitis is when your shoulder becomes very stiff, painful and hard to move. It happens when the tissue around the shoulder thickens and tightens, making it difficult to lift or rotate your arm. It starts with a pain which gradually increases and then the shoulder gets frozen. Frozen shoulder is usually seen in women than in men due to changes in hormone levels during menopause.

Causes:

The exact cause of frozen shoulder is not always known, but there are several factors which can increase the chance of developing one and those are:

• Immobility or lack of shoulder use:

This is the most common cause for frozen shoulder and it often happens after an injury, surgery or medical condition that requires a person to limit shoulder movement for an extended period of time.

• Inflammation and thickening of joint capsule:

The joint capsule around the shoulder can become inflamed due to irritation or injury. As the inflammation increases, scar tissue forms and the capsule thicken. This tightening process leads to the freezing phase.

• Medical conditions:

Individuals suffering from medical conditions like diabetes, thyroid disorders, heart disease, Parkinson’s disease and stroke are at a higher risk of developing a frozen shoulder.

• Aging:

As we age, joints become less flexible, and wear and tear can lead to joint stiffness, which may lead to frozen shoulder.

• Injury:

It can develop after an injury or trauma to the shoulder. The inflammation from the injury can trigger the process of shoulder capsule tightening.

• Surgical procedures:

Shoulder related surgeries or surgeries involving chest heart and breast can cause frozen shoulder due to prolonged immobility of the shoulder.

Symptoms:

• Freezing stage (first stage):

In this stage, pain will gradually increase and worsen over time, especially with movement. The person might experience pain while moving the shoulder, both actively (by themselves) and passively (with the help of someone else). This stage can last from 6 weeks to 9 months.

• Frozen stage (mid stage):

Stiffness of the shoulder increases and pain might decrease. In this stage, daily life activities involving shoulder becomes extremely difficult or even impossible. This stage can last up to 4 to 6 months.

• Thawing stage (late stage):
  Gradual return of shoulder mobility and reduced stiffness can be observed. You can also notice the pain wearing off gradually. This stage can last 6 months to 2 years as the shoulder returns to normal.

Frozen shoulder can take several months to even years to fully resolve based on the severity of the symptoms and the treatment received.

Treatment:

Treatment for frozen shoulder focuses on pain relief and improving movement.

1. Physical therapy: Stretching and mobility exercises tailored to gradually increase flexibility and strength are very effective.
2. Medications: Pain relivers and corticosteroid injections directed into the shoulder joints can ease pain especially during early stages.
3. Heat and cold therapy: Applying heat packs to shoulder before exercise can relax the muscle and ease stiffnesswhile ice packs can reduce numbness and ease pain.
4. Stretching: Gentle stretching and exercising at home as directed by a physiotherapist can gradually increase shoulder mobility.
5. Hydro dilatation:This procedure involves injecting large amount of sterile fluid into shoulder joint to stetch the capsule and improve movement.
6. Surgery:

Manipulation Under Anaesthesia (MUA): In this procedure, the shoulder is moved through its full range of motion when the patient is under general anaesthesia.

Arthroscopic surgery: A minimally invasive procedure where a surgeon cuts the tight portion of the joint capsule to increase mobility.

• Nerve block: A nerve block may be used to reduce pain and improve shoulder mobility by interrupting pain signals in the shoulder.
• Combination approach: A combination of physical therapy, pain management and corticosteroid injection is the most effective non-surgical approach towards frozen shoulder.

Conclusion: Frozen shoulder is a challenging condition that can significantly impact your daily life, limiting movement and causing persistent pain. For effective relief, it is essential to consult an experienced orthopaedic specialist who can accurately diagnose the condition and recommend the most appropriate treatment. Dr Banarji B.H, a highly skilled expert in orthopaedics who has extensive experience in treating frozen shoulder, utilizing the latest technology and tailored rehabilitation plans.