Does your shoulder feel stiff? Is this what you mean by 'frozen shoulder'?

Do you sometimes find it difficult to lift your shoulder or move your arm? Does it feel like your shoulder is stuck or stuck? Does it hurt when you try to change clothes, comb your hair, or lift your arm to pick up something? If these things are common to you, then you may have a condition called 'Frozen Shoulder' , or as doctors call it ``Adhesive Capsulitis'' . So, shall we talk about this in a little more detail today?

What is 'Frozen Shoulder'?

Simply put, a frozen shoulder is a painful condition that occurs in your shoulder joint. It is characterized by a gradual loss of the ability to move your shoulder. Specifically, the strong connective tissue surrounding your shoulder joint (called the Shoulder Joint Capsule) becomes thickened, stiff, and inflamed.

Imagine your shoulder joint as a ball-shaped piece of bone (called the humeral head) that fits into another ball-shaped piece of bone (called the glenoid). This is what we call a ball-and-socket joint. The capsule around that joint contains the ligaments that connect the upper arm bone to the shoulder blade.

So when this `(Capsule)` thickens and becomes tight, it becomes difficult to move the shoulder. You also reduce the use of the shoulder due to the pain. When you don't use it, that `(Capsule)` thickens and becomes tighter. Eventually, the shoulder becomes "frozen" in one place. That's why it's called a 'frozen' shoulder.

What are the symptoms of this? How does it develop?

Doctors divide the symptoms of this 'frozen shoulder' condition into three stages.

1. The “Freezing” Stage

This is the first stage. During this time, your shoulder will gradually become stiff and painful to move. The pain will gradually increase. The pain may be worse at night. It will also gradually become more difficult to move your shoulder. This stage usually lasts from six weeks to about nine months.

2. The “Frozen” Stage

When you reach the second stage, the pain may subside a little. But the shoulder will be very stiff and locked. This makes it very difficult to do everyday tasks, such as putting on clothes or combing your hair. This stage can last from two to six months.

3. The “Thawing” Stage

This is the final stage of recovery. During this time, pain decreases and the ability to move the shoulder gradually improves. The shoulder regains full or near-full strength and range of motion. This stage can last from six months to about two years.

Imagine, some people have to experience all three of these stages: first, being stuck with pain, then being stuck even though the pain subsides, and finally, slowly recovering.

What is the main reason why this 'frozen shoulder' develops?

In fact, researchers still don't know exactly what causes frozen shoulder. But we do know that the condition is caused by the capsule of the shoulder joint becoming inflamed, thickened, and stiff. Over time, scar tissue, known as adhesions, forms in the capsule. The synovial fluid that helps the shoulder joint function properly also decreases. This can limit the shoulder's ability to move and rotate freely.

Who is at higher risk of developing 'frozen shoulder'?

Some people are more likely to develop this condition. Let's take a look at who they are:

• Age: This most commonly occurs in adults between the ages of 40 and 60.
• Gender: This condition occurs more often in women than in men.
• Recent shoulder injury: If you have had an injury to your shoulder (for example, a rotator cuff tear, a fracture of the shoulder blade, collarbone, or upper arm bone), surgery, or immobilization of your shoulder (for example, wearing a sling), you are at higher risk of developing this condition. This is because the capsule tends to tighten when the shoulder is not being used.
• Diabetes Mellitus: Between 10% and 20% of people with diabetes develop frozen shoulder.
• Other health conditions: These include stroke, hypothyroidism, hyperthyroidism, Parkinson's disease, and heart disease. A stroke can limit the ability to move your arm and shoulder, which can lead to frozen shoulder. Researchers aren't sure how other conditions affect this.

How do doctors diagnose frozen shoulder?

If you have these symptoms, when you see a doctor, they will first ask you about your symptoms and take your medical history. Then they will do a physical examination of your arms and shoulders. Here are some things they will do:

• Your shoulder will be moved from side to side to check for range of motion and pain. This is called a "passive range of motion" test when the doctor moves your arm.
• Next, you will be asked to shrug your shoulders to see how your "Active Range of Motion" is.
• These two ranges of motion are compared. People with a 'frozen shoulder' have both limited active and passive ranges of motion.

Your doctor will often order an X-ray of your shoulder to rule out other conditions, such as arthritis. Frozen shoulder usually does not require an MRI or ultrasound. However, if your doctor suspects another condition, such as a rotator cuff tear, they may order these tests as well.

What are the best treatments for 'frozen shoulder'?

Treatment for frozen shoulder is usually pain-relieving in the early stages. If movement does not return to normal, physical therapy or surgery may be necessary.

Here are some simple treatments:

• Hot and cold compresses: These help reduce pain and swelling.
• Pain and swelling medications: These include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and acetaminophen. Your doctor may also prescribe other pain relievers/anti-inflammatory medications. Steroid injections can be used to control severe pain and swelling. Your doctor will inject a corticosteroid, such as cortisone, directly into your shoulder joint.
• Physical Therapy: A physical therapist will teach you stretching and range-of-motion exercises.
• Home Exercise Program: Your doctor or physical therapist can teach you exercises you can do at home.
• TENS (Transcutaneous Electrical Nerve Stimulation) therapy: This involves using a small battery-operated device to block nerve impulses and reduce pain.

If your pain and shoulder stiffness do not improve after about a year of non-surgical treatments, your doctor may recommend other treatments. These include:

• Manipulation Under Anesthesia: In this procedure, the doctor will put you to sleep and forcefully move your shoulder. This will stretch or tear your joint capsule, loosening the stiffness. This will increase your range of motion.
• Shoulder Arthroscopy: In this procedure, your doctor will cut and remove the tight parts of your joint capsule (capsular release). They will insert small, pencil-sized instruments through small incisions around your shoulder.

Doctors often use both methods together to achieve better results.

What is the outlook for 'frozen shoulder'? Will it heal?

Often, simple treatments such as painkillers and shoulder exercises, sometimes combined with a cortisone injection, can restore shoulder movement and function in a year or less. Sometimes, even without any treatment, shoulder range of motion and function gradually improve over time, but it is a very slow process. It usually takes about two years for a full or near-full recovery to occur.

Can frozen shoulder be prevented?

Yes, to some extent. If you have an injury to your shoulder that is painful or difficult to move, you can reduce your risk of developing a frozen shoulder by starting physical therapy as soon as possible . Your orthopedic surgeon or physical therapist can develop an exercise program that is tailored to your needs.

Finally, I have to say... (Take-Home Message)

Frozen Shoulder (Adhesive Capsulitis) can be a really difficult condition that can affect your daily life. The pain and stiffness in your shoulder joint can make it difficult or impossible to do everyday activities that you used to do without any problems.

The most important thing is to seek medical advice without enduring the pain if you have these symptoms.

If home treatments, such as rest and painkillers, don't help, see a doctor. They may recommend physical therapy or other non-surgical treatments first. Surgery is also an option for frozen shoulder that doesn't heal for a long time. Your doctor can help you choose the treatment that's best for you. So, don't be afraid to seek medical advice without delay.

` Frozen Shoulder, Shoulder Pain, Shoulder Stiffness, Adhesive Capsulitis, Shoulder Exercises, Physical Therapy, Arthritis