Frozen Shoulder

What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time, and then resolve, usually within one to three years. 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.

Symptoms

Frozen shoulder typically develops slowly and in three stages: • Freezing stage: Gradual onset of pain with increasing stiffness (6 weeks to 9 months) • Frozen stage: Pain may improve but stiffness remains, limiting daily activities (4 to 12 months) • Thawing stage: Gradual improvement in range of motion (12 to 42 months) • Pain that worsens at night • Progressive difficulty with overhead activities • Reduced ability to reach behind back

Diagnosis

Diagnosis usually involves: • Physical examination to assess active and passive range of motion • Discussion of symptoms and their progression • X-rays to rule out other causes like arthritis • MRI to look for other shoulder problems • Arthrogram to show restricted joint capsule • Assessment of risk factors (diabetes, previous immobilization) • Comparison with unaffected shoulder

Treatment

Treatment focuses on pain control and restoring range of motion: • NSAIDs and pain relievers • Corticosteroid injections into shoulder joint • Physical therapy with stretching exercises • Home exercises performed several times daily • Heat or ice application • Transcutaneous electrical nerve stimulation (TENS) • Hydrodilatation (injection of sterile water to stretch capsule) • Shoulder manipulation under anesthesia • Arthroscopic surgery to remove scar tissue and adhesions • Combination treatments often most effective

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