23/09/2018
Frozen Shoulder (Adhesive Capsulitis)
For Effective and affordable Frozen Shoulder treatment contact Matt Cox Physical Therapy
Ph: 0879500262
Email: matthewcoxnmt@gmail.com
Symptoms
This condition has been described in three phases, so the symptoms will differ depending on the phase of the condition:
1. The Painful Phase
Gradual onset of aching shoulder.
Developing widespread pain, often worst at night and when lying on the affected side.
This phase can last anywhere between 2-9 months.
2. The Stiffening Phase
Stiffness starts to become a problem.
Pain level usually does not alter.
Difficulty with normal daily tasks such as dressing, preparing food, carrying bags, working.
Muscle wastage may be evident due to lack of use. This stage can last between 4-12 months.
3. The Thawing Phase
Gradual improvement in range of movement.
Gradual decrease in pain, although it may re-appear as stiffness eases.
This stage can last between 5-12 months.
Frozen Shoulder Explained
Adhesive Capsulitis is the medical term for Frozen Shoulder sometimes abbreviated to FSS (frozen shoulder syndrome). This is a condition which affects the ability to move the shoulder, and usually only occurs on one side. Sometimes the problem can spread to the other shoulder (approximately1 person in 5).
The medical term literally describes what is seen in this condition adhesive meaning sticky, and capsulitis meaning inflammation of the joint capsule. It is thought that a lot of the symptoms are due to the capsule becoming inflamed and 'sticking', making the joint stiff and difficult to move. This is not the same as arthritis, and no other joints are usually affected.
Who does it affect?
Frozen Shoulder is extremely uncommon amongst young people, and is almost always found in the 40+ age group, usually in the 40-70 age range. Approximately 3% of the population will be affected by this, with slightly higher incidence amongst women, and five times higher prevalence in diabetics.
What causes it? There are two classifications of frozen shoulder syndromes:
Primary - No significant reason for pain/stiffness
Secondary - As a result of an event such as trauma, surgery or illness
It is not known exactly what causes this problem, however it is thought that the lining of the joint (the capsule) becomes inflamed, which causes scar tissue to form. This leaves less room for the humerus (arm bone) to move, hence restricting the movement of the joint.
The increased prevalence amongst diabetics (particularly insulin-dependent diabetics) may be due to glucose molecules sticking to the collagen fibres in the joint capsule, which causes stiffness. For this reason, diabetics are more likely to have both shoulders affected.
Hormonal changes may be responsible for the higher incidence amongst women, particularly due to the increased prevalence around the menopausal period.
Some studies have shown that poor posture, particularly rounded shoulders, can cause shortening of one of the ligaments of the shoulder, which may also contribute to this condition. Also, prolonged immobility (such as after a fracture) may cause this condition to develop.
Treatment - What can the patient do?
Seek medical advice if you think you may have
this condition, as early intervention can prevent severe stiffness.
Follow any advice given by medical professionals, particularly if participating in a rehabilitation program. Try to keep the shoulder moving even if it is just small pendular movements. If movement is very painful this should be ONLY under the guidance.
What can the doctor/therapist do?
This condition is usually managed conservatively, with surgery as a last measure if all other attempts fail.
Arrange a course of PhysicalTherapy
Oral steroids and/or anti-inflammatory medication to reduce inflammation.
Direct injection of steroid medication into the joint to reduce inflammation.
Nerve block a short term pain relief option, which is usually very effective.
Surgery if the above fails.
What does surgery involve?
Arthroscopic capsular release is the technique used most often
This involves dividing the thickened shoulder capsule Surgery is followed by an aggressive rehabilitation protocol which must be adhered to.
What is the likely outcome?
Most cases will resolve on their own or with treatment over a 1-3 year period, however it is a slow recovery process.
Some studies have reported positive results following arthroscopic surgery to release the tight capsule, however this is currently only offered to patients who have not improved with conservative treatment.
