Frozen Shoulder

What is Frozen Shoulder?

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Frozen shoulder is also known as adhesive capsulitis. It usually involves stiffness and pain that develops gradually in your shoulder joint. Treatment for Frozen Shoulder involves stretching and sometimes injecting of corticosteroids and numbing medications into the joint capsule.

In some cases, surgery is used to loosen the joint capsule so that it can move freely. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one or three years.

Symptoms of Frozen Shoulder

Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months.

  • Freezing or Painful stage: Any movement of your shoulder causes pain, and your shoulder's range of motion starts to become limited.
  • Frozen stage: Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and using it becomes more difficult.
  • Thawing stage: The range of motion in your shoulder begins to improve.

For some people, the pain worsens at night, sometimes disturbing sleep.

Causes of 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.

Doctors aren't sure why this happens to some people, although it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery or an arm fracture.

Risk factors :

Certain factors may increase your risk of developing frozen shoulder.

Age and sex:

People 40 and older particularly women are more likely to have frozen shoulder.

Immobility or reduced mobility:

People who have had prolonged reduced mobility of the shoulder are at higher risk of developing frozen shoulder. Immobility may be the result of many factors, including:

  • Rotator cuff injury
  • Broken arm
  • Stroke
  • Recovery from surgery
Systemic diseases

People who have certain diseases appear more likely to develop frozen shoulder. Diseases that might increase risk include:

  • Diabetes
  • Overactive thyroid (hyperthyroidism)
  • Underactive thyroid (hypothyroidism)
  • Cardiovascular disease
  • Tuberculosis
  • Parkinson's disease
Surgical procedures for Frozen Shoulder:

Most frozen shoulders get better on their own within 12 to 18 months. For persistent symptoms, your doctor may suggest:

  • Steroid Injections: Injecting corticosteroids into your shoulder joint may help decrease pain and improve shoulder mobility, especially in the early stages of the process.
  • Joint Distension: Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint.
  • Shoulder Manipulation: In this procedure, you receive a general anesthetic, so you'll be unconscious and feel no pain. Then the doctor moves your shoulder joint in different directions, to help loosen the tightened tissue.
  • Surgery: Surgery for frozen shoulder is rare, but if nothing else has helped, your doctor may recommend surgery to remove scar tissue and adhesion from inside your shoulder joint. Doctors usually perform this surgery with lighted, tubular instruments inserted through small incisions around your joint (arthroscopically).

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