What is Frozen Shoulder?
Also known as ‘Adhesive Capsulitis’, Frozen Shoulder is a condition affecting people generally aged between 40 and 60. Essentially, it is a “painful and stiff” shoulder. It is more common in people suffering from Diabetes Mellitus. Investigations such as certain blood tests and X-rays are normal.
This condition usually lasts between 6 months to 2 years, and can even last longer if not treated.
There are 3 Phases to Frozen Shoulder, each lasting several months:
Freezing: There is increasing pain and stiffness. The patient first complains of a painful shoulder, that ‘feels like a toothache’. This affects the sleep adversely especially when lying on the affected side.Graduallly, it gets more difficult to raise the arm sideway and to touch behind one’s head until it becomes impossible.
Frozen: The pain gradually subsides but the stiffness persists.
Thawing: The movements gradually return. However, many patients do not regain their full range of movement even after many years.
How would I get it?
The cause is uncertain, but there seems to be multiple inter-related causes. Some patients may recall a minor trauma to the shoulder before the onset of Frozen Shoulder. There may be “autoimmune” response by the body’s immune system to attack the injured shoulder tissues. There are also studies that showed that identical twins are more likely to get it if the other twin-sibling has it, suggesting a genetic predisposition. Diabetics are 4-5 x more likely to get it.
Can it be cured?
The condition is self-limiting. Treatment will improve on the range of movement and pain while the body heals itself.
How is it treated?
General Advice: There should be sufficient rest for both the patient and the affected shoulder. Resting the affected arm on a “Collar and Cuff” sling for short periods may help to relieve pain.
Physiotherapy: Heat, and often, Ice Packs will help in pain relief. Exercise that works through the range of shoulder movement will help, if it is conducted regularly and gently. However, this should be done after the acutely painful stage has subsided. One particular exercise is the “pendulum” exercise, whereby the patient leans forward at the hip, hanging the arm down and move it in a stirring movement. Acupuncture can often help relieve the pain and facilitate ROM exercises.
Medications: Oral painkillers such as Paracetamol and Diclofenac will help relieve the pain. Oral steroids are effective too. Occasionally, injection of steroids into the shoulder joint may be indicated.
Surgery: Manipulation Under Anaesthsia, whereby the Orthopaedic Surgeon manipulates the affected shoulder through certain movements while the patient is under anaesthesia. The result is significant pain relief and a possible shortened course of the disease process.
Surgical Release can be done either through an open surgery or an arthroscope.
When should I see a doctor?
There are many causes to shoulder pain and Frozen Shoulder is but one of them. Some of these are potentially serious: Ischaemic Heart Disease, Arthritis, TB, Gallstones among others. It is important to see a doctor if in doubt as to diagnosis of the shoulder pain.
This condition usually lasts between 6 months to 2 years, and can even last longer if not treated.
There are 3 Phases to Frozen Shoulder, each lasting several months:
Freezing: There is increasing pain and stiffness. The patient first complains of a painful shoulder, that ‘feels like a toothache’. This affects the sleep adversely especially when lying on the affected side.Graduallly, it gets more difficult to raise the arm sideway and to touch behind one’s head until it becomes impossible.
Frozen: The pain gradually subsides but the stiffness persists.
Thawing: The movements gradually return. However, many patients do not regain their full range of movement even after many years.
How would I get it?
The cause is uncertain, but there seems to be multiple inter-related causes. Some patients may recall a minor trauma to the shoulder before the onset of Frozen Shoulder. There may be “autoimmune” response by the body’s immune system to attack the injured shoulder tissues. There are also studies that showed that identical twins are more likely to get it if the other twin-sibling has it, suggesting a genetic predisposition. Diabetics are 4-5 x more likely to get it.
Can it be cured?
The condition is self-limiting. Treatment will improve on the range of movement and pain while the body heals itself.
How is it treated?
General Advice: There should be sufficient rest for both the patient and the affected shoulder. Resting the affected arm on a “Collar and Cuff” sling for short periods may help to relieve pain.
Physiotherapy: Heat, and often, Ice Packs will help in pain relief. Exercise that works through the range of shoulder movement will help, if it is conducted regularly and gently. However, this should be done after the acutely painful stage has subsided. One particular exercise is the “pendulum” exercise, whereby the patient leans forward at the hip, hanging the arm down and move it in a stirring movement. Acupuncture can often help relieve the pain and facilitate ROM exercises.
Medications: Oral painkillers such as Paracetamol and Diclofenac will help relieve the pain. Oral steroids are effective too. Occasionally, injection of steroids into the shoulder joint may be indicated.
Surgery: Manipulation Under Anaesthsia, whereby the Orthopaedic Surgeon manipulates the affected shoulder through certain movements while the patient is under anaesthesia. The result is significant pain relief and a possible shortened course of the disease process.
Surgical Release can be done either through an open surgery or an arthroscope.
When should I see a doctor?
There are many causes to shoulder pain and Frozen Shoulder is but one of them. Some of these are potentially serious: Ischaemic Heart Disease, Arthritis, TB, Gallstones among others. It is important to see a doctor if in doubt as to diagnosis of the shoulder pain.
posted by Tom and Len | 11:01 PM
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