Frozen shoulder also called adhesive capsulitis is happened when scar tissue forms in the shoulder joint’s capsule.
This causes it to thicken and tighten, that restricts shoulder movement and it may become stiff and painful.
Causes:
It is unclear why this happens.
Women and those over the age of 40 have a higher risk of developing frozen shoulder.
it is sometimes associated with endocrine disorders such as diabetes, and the outcomes are disappointing, regardless of treatment.
it is also associated with thyroid disorders, either Overactive (hyperthyroidism) or Underactive (hypothyroidism).
or a long period of immobilization following a fracture or shoulder surgery.
Symptoms.
pain occurs with any shoulder movement.
pain May worsen at night and cause difficulty sleeping.
the range of motion of the shoulder gradually becomes limited.
The symptoms appear slowly worsened gradually and usually take one to three years to resolve on their own.
Diagnosis.
To diagnose adhesive capsulitis of the shoulder, your doctor will ask about your symptoms and medical history.
Frozen shoulder is mainly diagnosed with a physical examination during which your doctor will evaluate your shoulder movements and assess for pain.
You'll be asked to perform certain arm movements to check active range of motion.
and your doctor will maneuver your arm in different directions to check passive range of motion.
External rotation deficit is the most common finding in physical examination.
He may order blood tests, to exclude other diseases such as diabetes and thyroid disorders.
X-ray may be ordered to view the shoulder joint and rule out other problems.
You don’t have to do MRI. It’s not necessary for diagnosis but can evaluate for other pathology.
Treatment.
Initial treatment may include non-steroidal anti-inflammatory drugs(N-saids)which reduce the pain and inflammation.
Hot or cold packs application for 15 min daily, can help reduce pain and swelling.
The treatment might also include going to a physical therapist for strengthening and stretching exercises to improve your range of motion.
It can take anywhere from a few weeks to nine months to see progress.
A home exercise program of gentle range of motion exercises is important.
Corticosteroid injections reduce inflammation and provide short-term relief.
Repeated corticosteroid injections are discouraged as they can cause further damage to the shoulder joint.
Manipulation under Anesthesia.
The shoulder joint is gently moved while the patient is under a general anesthetic.
During closed manipulation, the doctor moves the arm at the shoulder joint.
This is done to break up adhesions and loosen the stiff joint.
The goal of the procedure is to improve range-of-motion by breaking up scar tissue.
Frozen shoulder associated with insulin-dependent diabetes does not respond well to manipulation under anesthesia, often refreezing within 2 to 3 weeks.
The elderly, and osteoporotic should not be manipulated for fear of causing a fracture of the shaft or proximal humerus.
If you do not get relief from these methods, Suprascapular nerve block may be indicated for relief of chronic pain.
It provides pain relief that can last a few weeks to a few months.
However, recovery may be slow, and symptoms can persist for several years
In time and with treatment, most people with a frozen shoulder can improve their condition without surgery.
In a small percentage of cases, arthroscopic capsular release may be indicated to cut the tight capsule to allow the joint more freedom of mobility.
Rehabilitation after arthroscopic capsular release.
You should be able to go home the same day.
You do not need to wear a sling and aim to use your shoulder as much as possible.
Physical therapy will begin immediately following the surgery to ensure that scar tissue does not begin to re-form around the joint.
Most people in desk-based jobs are able to return to work at around three to four weeks.
but jobs requiring significant manual work or heavy lifting often require at least six weeks off work.
Total recovery following surgery can take three months or longer.


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