Upper Extremity Surgery – Frozen Shoulder
Frozen shoulder is a disorder caused by the inflammation, scarring, and shrinking of the shoulder capsule. Any type of injury to the shoulder joint may lead to a frozen shoulder.
- Aching shoulder pain
- Limited movement of the joint
- Pain, especially when sleeping on injured side
- Anti-inflammatory medication
- Cortisone injections when necessary
- Exercise program and therapy
- Surgery for severe cases
What is Frozen Shoulder?
Frozen Shoulder (medical term: adhesive capsulitis) is a condition of the shoulder that can result in pain, and restricted movement of the shoulder in all directions. More common in women than in men, and more likely to appear after age 50, the condition often starts as mild pain and stiffness without a specific cause. The pain and stiffness increase very gradually over a period of months, and can interfere with your ability to sleep. Increasingly, it can become more difficult to lift your arm upward, or move it backwards.
What causes it?
There is no clear cause for most cases of Frozen Shoulder. It affects approximately 2% of the general population, and because the onset of symptoms is subtle, many people don’t realize something specific is wrong. Some research points to conditions that seem to increase your risk of developing the condition.
Diabetes. Although the connection is not known, Frozen shoulder is seen much more often in people with diabetes, affecting 10% to 20% of them.
Other diseases. Other medical problems that seem to be associated with frozen shoulder are hypothyroidism, hyperthyroidism, Parkinson’s disease, and cardiac disease.
Immobilization. The condition can emerge after your shoulder has been immobilized because of surgery, a fracture, or other injury. Avoiding frozen shoulder is one reason that doctors recommend that patients begin moving their shoulders soon after injury or surgery.
What are the symptoms and diagnosis?
Shoulder Anatomy. The shoulder joint is naturally lubricated by a gel-like material called synovial fluid.
Symptoms. In frozen shoulder, the joint capsule tightens as scar-like adhesions form. This causes it to thicken, and the shoulder stiffens up. Because there is seldom an injury or other obvious cause, your doctor will examine your ability to move, on the way to assessing how far the condition has progressed. In more severe cases, you can’t move the joint at all, even with someone else helping to push on it.
Diagnosis. Your doctor will assess your ability to move your shoulder by yourself, and also test how much it can rotate with someone else’s help. This is called range of motion assessment. The doctor will also make note of how much pain is associated with movement. The doctor might also order X-ray studies for a closer look at changes in the bones, such as arthritis, or an MRI to get a detailed assessment of soft tissue, such as a damaged rotator cuff.
What is the treatment for Frozen Shoulder?
Unless there’s an underlying medical problem, Frozen Shoulder usually gets better over time, but this could take many months or even years.
Treatment. In typical cases, your doctor will recommend nonprescription pain relievers like ibuprofen or acetaminophen, along with physical therapy or home exercises to begin restoring your full range of motion. Treatment for more advanced cases can include injection of steroids into the joint to relieve inflammation, or arthroscopic surgery to trim the tightened fibrous material around the joint. This would be followed by physical therapy to help you restore your range of motion.
American Academy of Orthopedic Surgeons http://orthoinfo.aaos.org/topic.cfm?topic=A00071
PubMed Health http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025851/