FROZEN SHOULDER
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Frozen shoulder or medically referred as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff.
Pain is usually constant, worse at night, and when the weather is colder and along with the restricted movement can make even small tasks impossible. Certain movements or bumps can cause sudden onset of tremendous pain and cramping that can last several minutes.

Symptoms
Frozen shoulder typically develops slowly, and in three stages. Each of these stages can last a number of months.

1. ‘Freezing’ stage or Painful stage.
a. During this stage, pain occurs with any movement of your shoulder, and your shoulder’s range of motion starts to become limited. It may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion.

2. Frozen stage or adhesive stage
a. Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and your range of motion decreases notably. It is marked by a slow improvement in pain but the stiffness remains. This stage generally lasts from four to nine months.

3. Thawing stage.
a. During the thawing stage, the range of motion in your shoulder begins to improve. This generally lasts from 5 to 26 months.
For some people, the pain worsens at night, sometimes disrupting normal sleep patterns.

Causes
The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. Most people with frozen shoulder have suffered from immobility as a result of a recent injury or fracture. It is common in people with diabetes.

Risk factors
1. Age – being over 40 years of age.
2. Gender – 70% of people with frozen shoulder are women.
3. Recent surgery or arm fracture – immobility of recovery may cause the shoulder capsule to stiffen.
4. Diabetes – two to four times more likely to develop frozen shoulder for unknown reasons; symptoms may be more severe.
5. Having suffered a stroke.
6. Hyperthyroidism (overactive thyroid).
7. Hypothyroidism (underactive thyroid).
8. Cardiovascular disease (heart disease).
9. Parkinson’s disease.

Treatment

Conservative
1. Painkillers
2. Corticosteroid injections – a type of steroid hormone that reduces pain and swelling. Corticosteroids may be injected into the shoulder joint to alleviate pain, especially in the ‘painful stage’ of symptoms. However, repeated corticosteroid injections are discouraged as they could cause damage to the shoulder.

Non-conservative
Physiotherapist
1. Cold compression packs – to reduce swelling.
2. Hot pack – to reduce pain
3. Ultrasound – to reduce inflammation
4. Transcutaneous electrical nerve stimulation (TENS)
5. Shoulder / scapula manipulation
6. Taping

Kinesio_Taping_FrozenShoulder4

7. Exercises to maintain as much mobility and flexibility as possible without straining the shoulder or causing too much pain.

frozen shoulder exs

Source :
• Medline plus encyclopedia
• Mayoclinic
• Dr Ko Ko Gyi’s blog
• Medical news today

Prepared by:
Nurul Syafiqah Binti Kasin
Physiotherapist,
e-Wellness Johor Bahru Branch.

 

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