Frozen Shoulder

Frozen shoulder, also called ‘adhesive capsulitis’, is a shoulder problem in which the shoulder joint gradually becomes stiff and painful. Signs and symptoms appear slowly, then get worse. Over time, the stiffness starts to improve, and this disease is self limiting, but it may take as much as 2 to 5 years for it to improve completely.

What happens in Frozen Shoulder and what are its symptoms?

In frozen shoulder, the tissues in your shoulder joint thicken and become stiff. Bands of scar like tissue form around the joint and all your shoulder movements become increasingly painful. The less you move it because of pain, the thicker the tissues become,a nd the joint becomes more and more stiff. Over time, you feel that your shoulder is stuck in one position, hence the term “FROZEN”.

Because of stiffness, initially you have problems in doing overhead activities like reaching out toan object on a high shelf, hanging clothes on a wire, etc. Reaching to objects placed at the back is painful, and activities like tying your seat belt in the car become difficult. You feel a dull pache in your shoudelr which is more at night, and gradually, it affects your sleep. With time, the stiffness restricts even your activities of daily living like combing, bathing and personal hygiene.

What causes Frozen Shoulder?

The cause of frozen shoulder is not yet fully understood. However, some people have more chances of developing this disease. It is more common between the ages of 40 and 60. Having to keep a shoulder still for a long period increases the risk of developing frozen shoulder. This might happen if you recently had a surgery on your arm or an injury to your arm. If you are recovering from a medical condition like a stroke or any other surgery that keeps you from moving your arm, you have a risk of developing frozen shoulder. 

Frozen shoulder is very common in diabetes. Around 20% of people with diabetes get frozen shoulder at some point of time! It is also more common in people with thyroid problems. Some people develop frozen shoulder one by one in both shoulders.

How is it Diagnosed?

Your doctor will do a physical examination to make a presumptive diagnosis. Sometimes, stiffness may be because of other problems like arthritis, torn rotator cuff or stiffness after a fracture. Your doctor may order X rays, ultrasound and MRI as required to rule out other problems.

What is the treatment for frozen shoulder?

Mobilisation: The most important treatment is range-of-motion exercises. 

Medicines: The patient is given short courses of medications to reduce inflammation and control pain.

Physical and electrotherapy: Various physiotherapy modalities are used like ice and heat as required, physical therapy and electrotherapy. It is best to join a regular therapy program.

Joint injections: If needed, your treating doctor may inject corticosteroid or other injections inside your joint. 

Arthroscopic (keyhole) surgery: Sometimes, a keyhole surgery (arthroscopic release) is needed to loosen and divide the thick tissues in the joint so that the recovery becomes faster.

Shoulder manipulation: It can help loosen up your shoulder tissue, but is very rarely used in solation because the keyhole surgery is safer and has better results.

How much rest is required after the Keyhole Surgery?

Bare minimum rest is required after this surgery. In fact, the aim of the surgery is to improve the movement, so you will be encouraged to start your mobilisation exercises from day 1. 

What can be done to prevent Frozen Shoulder?

It may not be possible to completely prevent frozen shoulder. You can include shoulder mobilisation and strengthening exercises in your daily routine. You can go for regular health check-ups to timely detect diabetes or thyroid problems. Once detected, you should regularly follow your doctor’s advice to keep your diabetes and thyroid problems under control.