If you’re experiencing unbearable pain, limited movement of the shoulder, and stiffness in your shoulder joint, it’s probably the result of a frozen shoulder. This condition doesn’t last for a couple of days and can persist over weeks, months and can get worse as time passes. Medical conditions and procedures that prevent the mobility of the arm and movement of the shoulder joint can lead to a frozen shoulder. A frozen shoulder can last for a couple of years and may take years to recover. Oral medication, exercises, and surgery are some ways to treat this condition.
1. Symptoms
- Pain: Excessive pain in the shoulder that doesn’t seem to go away and has become permanent during all times of the day is a clear sign of a frozen shoulder. It’s not normal pain that might occur from tiredness or overwork – but a deep-seated, excruciating pain.
- Stiffness: The joint feels very stiff and hard to stretch. If an affected person tries to move their shoulder beyond a certain extent, it leads to more pain and doesn’t stretch as intended.
- Inability To Move: This may result from stiffness or pain in the shoulder. The patient suffers from immobility of the shoulder and is unable to perform regular tasks using the arm with the frozen shoulder.
2. Causes
- Inflammation: When the tendons and muscles surrounding the shoulder joint become inflamed, it can lead to tightness in the area and a frozen shoulder. The swelling can result in pain which can add to discomfort of your shoulder while trying to perform usual tasks.
- Immobilization: If the arm or the shoulder is not used for some time, the shoulder may become frozen in one place. This can be an after effect of an injury that requires the arm to be tied or held in a certain position to heal properly. It’s necessary to perform required exercises even during a recovery phase to prevent a frozen shoulder.
- Medical Conditions: There are some medical conditions that can lead to a frozen shoulder. Individuals who are diabetic are more prone to developing this condition. Similarly, the people suffering from hypothyroidism, Parkinson’s disease, and cardiac problems can also complain of a frozen shoulder.
- Thickening Or Shrinking Of Capsule: If the connective tissue which encapsulates the glenohumeral joint (shoulder joint) thickens or shrinks beyond its usual size, it can freeze the shoulder in one place which can result in immobility and pain of the joint.
3. Stages
There are three stages of a frozen shoulder which are experienced by a patient before they recover from this condition.
Freezing Stage: The movement of the shoulder causes extreme pain and it becomes relatively difficult to carry out the day-to-day tasks with the arm of the affected shoulder.
Frozen Stage: The shoulder becomes stiff and its mobility is drastically reduced, you may not be able to move the joint at all. Any flexibility that may have been present earlier turns into the inability to stretch the arm of the shoulder at all.
Thawing Stage: The mobility of the shoulder gradually returns to normal, the stiffness wears off, and the pain goes away with time as well, it can take 6 months to 2 years for the shoulder to return to its original condition.
4. Treatment
A frozen shoulder can be treated using various methods and techniques. The procedure depends on the severity of the condition, the age of the patient, and the risks that might be present due to other health issues. Some of these treatments are completely non-invasive and satisfactory while others are more prolonged and involve surgery.
Pain Killers
The pain relievers prescribed by a doctor may include aspirin and ibuprofen that can help manage the pain, discomfort, and swelling of the tissues and muscles surrounding the shoulder joint. In the case of advanced frozen shoulder condition, stronger pain killers may be recommended. However, it’s advised not to take any medicines without consulting a physician as they can have severe side-effects especially if you’re being treated for other medical problems such as diabetes, heart disease, breathing problems, etc.
Physiotherapy
Even though the shoulder becomes stiff and its ability to stretch and range of motion is reduced greatly, physiotherapy can help regain the lost strength and also counter the pain and contraction of the muscles and tendons. There are a number of exercises involved in physiotherapy for a frozen shoulder:
- Pendulum Stretch: By placing the arm of the healthy shoulder on a table, let the arm of the affected side hang freely in the air. Rotate the hanging arm clockwise and anticlockwise for 15 to 30 seconds, respectively. The diameter of this rotation can be adjusted according to the stiffness of your frozen shoulder and it can be increased as you start to notice the recovery from this condition. This exercise can be repeated throughout the day for a faster cure.
- Towel Stretch: Hold a twisted towel with both of your hands behind your back. You can either hold it in a vertical position or a horizontal position to perform this exercise. Gently pull the towel towards the unaffected side using your fit arm or upwards with your good hand, respectively. This will help increase the mobility of the shoulder and reduce stiffness over time.
- Finger Walk: Place two of your fingers (the index finger and the middle finger) on a wall with a slightly bent elbow on the level of your waist. Move the fingers upwards to the level of your shoulder and downwards to the level of your waist. Don’t move it any farther than you can manage without causing pain in the frozen shoulder. This movement should imitate the ‘walking’ action using the fingers. Don’t put too much strain on your shoulder but rely on your fingers for this activity. You can repeat this exercise several times a day.
- Cross-body Reach: Hold your affected arm from the elbow using the palm of your other hand and lift the arm across the body on the level of your chest. You can repeat this exercise 10 to 15 times a day, but be careful to not put too much pressure on the muscles of the frozen shoulder as it can worsen its condition.
- External And Internal Rotation: Both of these exercises are performed using a rubber exercise band. You can hold the band with both of your hands while your arms are at a 90 degree angle. Using the strength of your arm, rotate its lower part outwards and hold it in that position for 5 to 10 seconds, this results in external rotation of the joint. Similarly, use a door knob to keep one end of the band stationary while pulling the other end a few inches away from the door and towards your body with the hand of the affected arm. Hold it in that position for 5 to 10 seconds, this is an internal rotation exercise.
It’s advised that a patient should consult an expert physiotherapist before adopting any kind of exercise. An expert can guide you in the best possible way and suggest physical activities and exercises that will improve the condition of the frozen shoulder. Trying to manage such medical problems at home without sufficient knowledge of the body’s musculoskeletal system can worsen the situation and lead to more damage than recovery.
Cold Laser Therapy
The frozen shoulder treatment provided using cold laser therapy – also known as Low Level Laser Therapy (LLLT) – is a procedure carried out by expert doctors and physicians. In this procedure, a handheld device is used to treat the frozen shoulder with low-intensity laser light that encourages increased blood flow and reduces inflammation and swelling. This results in decreasing the pain and stiffness of the joint and improving its range of motion. It’s a very effective, non-invasive method of treating a frozen shoulder, irrespective of its cause. It;s a painless procedure that doesn’t require medication or incisions.
Injections
- Steroid Injections: Corticosteroids are known to have anti-inflammatory effects and reduce the swelling in the tissue and muscles surrounding the shoulder joint. This can relieve the pain and stiffness of the arm and recover its mobility.
- Hydrodilatation: A radiologist administers the hydrodilatation injection using imaging. By injecting sterile fluid in the shoulder joint, it’s possible to expand the shoulder joint capsule, this can decrease its contraction and stiffness.
Shoulder Arthroscopy
Small incisions are made around the shoulder joint to insert equipment into the affected area and remove the damaged tissues. These tissues might be inflamed or injured which results in a frozen shoulder. This procedure is performed infrequently as it’s the last resort to treat a frozen shoulder which couldn’t be healed with any other method.
