Frozen Shoulder: Causes, Symptoms, Treatments - All About Physical Therapy

Frozen shoulder, otherwise known as adhesive capsulitis, is a condition in the shoulder characterized by stiffness, pain, and limitation of motion. It is typical in frozen shoulder to involve only one, although, few cases affect both shoulders. 

Causes:

Frozen shoulder usually happen after a recent injury or after a medical procedure or from, a medical condition such as stroke, diabetes, or mastectomy. The inability of moving the shoulder into its full range of motion because of pain results in stiffness of the tissues around the joint. Later on, shoulder movement becomes more difficult and painful.

Symptoms:

This shoulder condition usually develops gradually, becomes worse over time and then slowly resolve over the course of 1 year up to 3 years. Persistent pain and limitation of motion from joint stiffness are the most obvious symptoms seen in people with frozen shoulder. This condition develops in 3 stages and each stage can last up to several months.

Freezing Stage 

• The painful stage. More and more pain is experienced when you do any movement of the shoulder. Limitation of motion starts to become limited.

Frozen Stage

• Pain begins to diminish at this stage, but the stiffness still remain making shoulder movement difficult affecting daily activities.

Thawing Stage

• Shoulder movement slowly improves at this stage.

Risk Factors:

• Age. Common to people aged 40 to 70 years
• Gender.More often to women than in men
• After surgical procedure 
• Recent injury such as fracture
• Medical problems such as stroke, hyperthyroidism, hypothyroidism, diabetes, Parkinson's disease, or cardiac disease

Diagnosis and Test:

• Medical History to include a detailed description of the symptoms, present and past medical conditions, and medications and/or supplements taken.
• Physical Examination to include testing the range of motion of both shoulder joints. The affected shoulder will show limited motion, both active and passive.
• Imaging Test
• X-rays, which shows a clear image of the bone, help find other problems in the shoulder.
• Ultrasound and MRI give a better view of the soft tissues to rule out other problems.

Treatment

The aim of treatment for frozen shoulder is to ease pain and keep the mobility and flexibility of the shoulder. Here are some of the recommended treatment approaches of frozen shoulder.

• Medications. Over the counter pain-relieving and antiinflammatory drugs, such as aspirin and ibuprofen to cut pain and swelling.
• Heat application followed by gentle stretching to increase range of motion.
• Range of motion exercises, given by a physical therapist, to recover shoulder joint mobility.
• Ice and corticosteroid injection will help reduce pain and swelling.
• Transcutaneous Electrical Nerve Stimulation (TENS) give pain relief by blocking pain fiber that carries pain impulses.
• Joint Distention. A sterile water is injected into a joint to stretch the tissue so that movement is easier
• Shoulder Manipulation under anesthesia. You will receive general anesthesia and the doctor do manipulation to break adhesion.
• Shoulder Arthroscopy. This procedure is rarely done. The doctor uses a lighted, tubular instrument inserted into a small incision around the joint to remove scar tissue and adhesions.