CONDITION OF THE MONTH - MAY

FROZEN SHOULDER

What is a Frozen Shoulder?

Frozen shoulder or adhesive capsulitis, is a condition that causes restriction of motion in the shoulder joint. The cause of a frozen shoulder is not well understood, but it often occurs for no known reason. Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue.

What causes frozen shoulder?
Most often, frozen shoulder occurs with no associated injury or discernible cause. There are patients who develop a frozen shoulder after a traumatic injury to the shoulder, but this is not the usual cause. Some risk factors for developing a frozen shoulder include:

· Age & Gender
Frozen shoulder most commonly affects patients between the ages of 40 to 60 years old, and it is twice as common in women than in men.

• Endocrine Disorders
  Patients with diabetes are at particular risk for developing a frozen shoulder. Other endocrine abnormalities, such as thyroid problems, can also lead to this condition.
• Shoulder Trauma or Surgery
  Patients who sustain a shoulder injury, or undergo surgery on the shoulder can develop a frozen shoulder joint. When injury or surgery is followed by prolonged joint immobilization, the risk of developing a frozen shoulder is highest.
• Other Systemic Conditions
  Several systemic conditions such as heart disease and Parkinson's disease have also been associated with an increased risk for developing a frozen shoulder.

What happens with a frozen shoulder?
No one really understands why some people develop a frozen shoulder. For some reason, the shoulder joint becomes stiff and scarred. The shoulder joint is a ball and socket joint. The ball is the top of the arm bone (the humeral head), and the socket is part of the shoulder blade (the glenoid). Surrounding this ball-and-socket joint is a capsule of tissue that envelops the joint.

Normally, the shoulder joint allows more motion than any other joint in the body. When a patient develops a frozen shoulder, the capsule that surrounds the shoulder joint becomes contracted. The patients form bands of scar tissue called adhesions. The contraction of the capsule and the formation of the adhesions cause the frozen shoulder to become stiff and cause movement to become painful.

A frozen shoulder causes a typical set of symptoms that can be identified by your doctor or physical therapist. The most important finding is restricted movement. Other shoulder conditions can cause difficulty with movement of the shoulder, such as a rotator cuff tear; therefore it is important to have an examiner familiar with this condition for a proper diagnosis.

What are the typical symptoms of a frozen shoulder?

· Shoulder pain; usually a dull, aching pain

· Limited movement of the shoulder

· Difficulty with activities such as brushing hair, putting on shirts/bras

· Pain when trying to sleep on the affected shoulder

Types of Treatments

Frozen shoulder treatment primarily consists of pain relief and physical therapy. Most patients find relief with these simple steps, although the entire treatment process can take several months or longer.

· Exercises and Stretching
Stretching exercises for frozen shoulder serves two functions:

· First, to increase the motion in the joint

· Second, to minimize the loss of muscle on the affected arm (muscle atrophy)

The importance of stretching and exercises cannot be overemphasized as these are the key to successful frozen shoulder treatment. Patients cannot expect to have successful frozen shoulder treatment if they perform exercises only when working with a therapist. These exercises and stretches must be performed several times daily.

Moist Heat
Applications of moist heat to the shoulder can help to loosen the joint and provide relief of pain. Patients can apply moist heat to the shoulder, then perform their stretching exercises--this should be done at least three times daily. Moist heat can be applied by using a hot-soaked washcloth on the joint for 10 minutes before stretching.

Physical Therapy
Physical therapists can help a patient develop a stretching and exercise program, and also incorporate ultrasound, ice, heat, and other modalities into the rehabilitation for frozen shoulder. As said previously, it is important that patients perform their stretches and exercise several times daily--not only when working with the therapist.

Anti-inflammatory Medications
Anti-inflammatory medications have not been shown to significantly alter the course of a frozen shoulder, but these medications can be helpful in offering relief from the painful symptoms.

If you have persistant shoulder pain, you can see one of our physical therapist. In the state of Pennsylvania, you can seek treatment from a physical therapist WITHOUT a physician’s prescription. You can usually be seen by one of our physical therapists within 48 hours. If needed, we can refer you to one of the orthopedic surgeons we work closely with who are located closest to where you live.