What is Frozen Shoulder Syndrome?

What is Frozen Shoulder Syndrome?

What is Frozen Shoulder (Adhesive Capsulitis)?

Frozen shoulder, also known as adhesive capsulitis or more recently referred to in some studies as shoulder contracture syndrome, is a condition characterized by pain and stiffness in the shoulder joint. If you experience pain during movement or have difficulty sleeping due to shoulder pain, particularly in the evening or morning, you might suspect frozen shoulder. Contracture refers to the joint becoming locked in a certain direction, preventing movement in that direction, which is also seen in frozen shoulder syndrome.

Frozen Shoulder Contracture Syndrome - Aetiology, Diagnosis and Management

What is Frozen Shoulder?

Frozen shoulder is a condition where inflammation of the fluid within the shoulder joint, thickening of the joint capsule, and some ligaments in the shoulder lead to restricted shoulder movements, with the restriction worsening over time. This condition is often unilateral and can be confused with other health issues like rotator cuff tears or hernias.

Causes of Frozen Shoulder

Adhesive capsulitis is often idiopathic, meaning it can occur without any specific cause. However, it can also be associated with conditions such as:

  • Diabetes
  • Thyroid disorders
  • Stroke
  • Post-surgical conditions

Additionally, many cases seen in clinics involve the non-dominant shoulder, especially following surgery, fractures, or long periods of immobility.

Prevalence and Demographics

Frozen shoulder is more commonly seen in women, accounting for about 70% of clinical cases, typically between the ages of 35-65.

Symptoms of Frozen Shoulder

Patients typically present with gradually worsening pain that becomes severe quickly, along with restricted movement in both active and passive motions. Common complaints include:

  • Difficulty with self-care activities such as dressing or combing hair
  • Inability to lift the hand behind the back
  • Pain that awakens one from sleep, making it difficult to sleep on the affected side

Stages of Frozen Shoulder

Patients presenting with adhesive capsulitis can be classified into three stages:

  1. Stage 1: Pain gradually increases and peaks with movement. Night pain often wakes the patient, and rest exacerbates the discomfort. Inflammation within the joint and a reduction in joint fluid lead to a narrowing of the joint space.

  2. Stage 2: Pain diminishes but significant joint restriction causes severe pain with movement. This stage can last from the fourth month to the twelfth month.

  3. Stage 3: Known as the resolution phase, during which night pains significantly subside, but movement restriction persists. This stage is seen in about 40% of patients and can last up to three years. The duration can be shortened with quality and adequate treatment.

Diagnosis of Frozen Shoulder

The diagnosis of adhesive capsulitis is made by a physician based on a thorough evaluation of your history and symptoms. If necessary, an MRI may be used to support the diagnosis.

Treatment of Frozen Shoulder

Treatment for adhesive capsulitis should consider the stage of the condition. For instance, early-stage patients experiencing severe pain with every movement should be treated cautiously, potentially with medical support. In contrast, patients in the second or third stage may benefit from more aggressive stretching exercises to improve joint movement. The treatment process should start gently and gradually increase in intensity without damaging the tissues. Treatment options include:

  • Physical therapy
  • Manual therapy
  • Mobilization
  • Manipulation
  • Pain-relieving injections
  • Surgical manipulation of the joint capsule under anesthesia

Frequently Asked Questions

Who is at Risk for Frozen Shoulder?

  • Women, more commonly than men
  • Individuals aged 40+
  • Those with a sedentary lifestyle, diabetes, thyroid disorders, Parkinson’s disease, or stroke

Can Frozen Shoulder Be Treated at Home?

If diagnosed with adhesive capsulitis, consult your physician for necessary evaluations and medical support. Subsequently, you can seek help from physical therapists for at-home physical therapy.

Can Frozen Shoulder Heal on Its Own?

Yes, it can. However, some cases may continue to experience joint restriction and discomfort. To avoid long-term issues, seeking appropriate treatment upon diagnosis is advisable.

Will My Shoulder Function Return to Normal?

Most frozen shoulder cases can return to normal life with proper treatment. Nonetheless, a small number of patients might experience persistent movement restrictions.

Frozen shoulder is a manageable health problem, particularly with the help of physical therapists, and while it initially causes significant discomfort, it can be effectively addressed with proper care.

Wishing you healthy days!

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