Frozen Shoulder | What is Frozen Shoulder?

The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement.

The exact causes of frozen shoulder are not known, but there are a number of risk factors:
 

Gender and age

People aged 40 or above are more likely to develop frozen shoulder.
 

Immobility

People with prolonged immobility due to rotator cuff injury, broken arm, stroke or other surgeries will have a higher risk of developing frozen shoulder.

Systemic diseases

People with certain medical conditions are predisposed to this disease. They include:

• Diabetes
• Parkinson’s disease
• Hypothyroidism
• Hyperthyroidism
• Cardiac disease
• Tuberculosis

The main symptoms of frozen shoulder include decreased motion, pain and stiffness of the shoulder. Most of the cases start with pain, which prevents you from moving your arms. It further leads to stiffness and limited motion. Some actions such as reaching over your head or behind you become more difficult.

Physical examination

Your doctor may ask you to perform a range of motions, including raising your hands up in the air; reaching across your chest to touch your opposite shoulder; and doing back scratch. Your doctor may also ask you to relax your muscles while he or she moves your arm for you. This test can help distinguish between frozen shoulder and a rotator cuff injury.

Imaging tests

Your doctor may order one or more of the following tests for you:

• X-ray: This uses radiation to produce an image of the inside of your shoulder
• Magnetic resonance imaging (MRI): This uses magnetic field and radiowaves to produce images of the inside of your shoulder
• Ultrasound. This uses sound waves to produce an image of the inside of your shoulder

These tests can rule out other causes of your shoulder stiffness and pain, such as rotator cuff injury or osteoarthritis.

Non-surgical treatments

Non-steroidal anti-inflammatory medicines: Drugs like ibuprofen can reduce pain and swelling.

Cortisone injections: Injection of a local anesthetic and a cortisone preparation is a very effective way to alleviate pain.

Joint distension: Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint.

Physiotherapy: Your physiotherapist will design a specific exercise program based on your own situation. They should be done under supervision, or at home at your own convenience. They include stretching exercises for the shoulder, as well as using heat to loosen the shoulder up before stretching.

Surgical treatments

Shoulder manipulation: It is a procedure to be done under general anesthesia that makes you unconscious and with no pain. Your surgeon will move your shoulder joint in different directions to help loosen the stiff tissues. However, this procedure can cause bone fractures.

Shoulder arthroscopy: Your doctor will cut through tight portions of the joint capsule. This procedure is to be done by small instruments inserted through small incisions around your shoulder. Sometimes, arthroscopy is to be done in combination with shoulder manipulation for a better result.