What can I do about Frozen Shoulder?

What is it?

Frozen shoulder, or adhesive capsulitis, is a term that describes a condition in your joint that starts out with pain, then progresses into stiffness and lack of mobility, then eventually returns to normal. It generally strikes adults between the ages of 40 and 60, and tends to affect women more than men.

On visualizing the joint with scope we would find thickened ligaments and cartilage, swelling, and excessively tight connections — maybe even some scar tissue

What is the cause?

Although an injury can lead to a frozen shoulder, it’s generally not the cause of it. long stints of immobility cause the tissues in your shoulder to swell, thicken, and stiffen. Likewise, extended illness or even surgery — anything that makes you sedentary — can contribute to frozen shoulder syndrome.

Diabetes and thyroid conditions also put you at greater risk for frozen shoulder, so properly monitoring your symptoms can help you prevent your shoulder from seizing up.

Stages of frozen shoulder – Typically, frozen shoulder progresses through three stages of development over a period of about two or three years.

•  Freezing
  In the beginning, you notice twinges of pain that become progressively worse. During this “freezing” phase, your joint becomes stiffer, more painful, and you find that your range of motion has decreased. This stage lasts two to nine months.
• Frozen
  Most people report that for the next four to six months, their pain subsides somewhat, but the “frozen” part is still very real. They simply can’t move the joint to perform everyday tasks.
• Thawing
  After the first year, those who suffer from frozen shoulder syndrome begin to gain some hope. Their joint begins to loosen up, and they regain some of the range of motion. Over time (up to three years), the shoulder eventually returns to normal function.

What are the treatment options?

What you can do about frozen shoulder syndrome

Given enough time, your frozen shoulder may resolve itself without intervention, but three years is a long time to go without the use of your shoulder. Here are your treatment options.

Physical therapy

Although it may seem counterintuitive (and painful), movement is the best medicine for your frozen shoulder. There is no substitute for physical therapy, including passive stretches and strategic flexes that encourage your joint to speed up the healing process. It may help to
apply gentle heat to your shoulder before your exercises and ice afterward.

Anti-inflammatory treatments

Since inflammation is one of the main culprits causing your frozen shoulder, reducing that swelling can bring you significant pain relief.

Over-the-counter anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin can take the edge off your intense pain so that you can continue with your physical therapy.

Surgery

Surgery is not always necessary to treat adhesive capsulitis, but when scar tissue has built up and your body won’t heal itself, you may need to have some of that extra tissue removed.

There are two main ways we can help.

• One is non invasive where we manipulate the shoulder joint under anaesthesia and start on physiotherapy immediate postoperatively.
• Second is arthroscopy aided capsular release.

Both have excellent outcomes depending on what stage the presentation is, but in most cases full recovery is expected. Hence early diagnosis and physical therapy is imperative.

Dr. Nikhil Manvi
Assistant Professor
MBBS, MS Orthopedics, Fellowship in Joint replacement and Fellowship in Arthroscopy.