Frozen shoulder, or clinically known as Shoulder Adhesive Capsulitis, is a type of local pain that occurs slowly on a shoulder. Despite the ability to perform daily routines, the person affected with frozen shoulder experiences difficulty in moving the affected shoulder actively and passively.
A pathological study by T.D. Bunker looked into microscopic structures seen in specimens taken from patients who were diagnosed to have a primary frozen shoulder and underwent surgical release of coracohumeral ligament. The histological examination and immunochemistry results found out that the main configurations of the specimens were fibrous connective tissues, while inflammatory cells are seen to be very few. This denotes that a frozen shoulder is not an inflammatory condition, but a fibrosing condition.
How Frozen Shoulder is Diagnosed
Diagnosis is based on clinical manifestations of the patient suffering from shoulder pain. The criteria are listed below:
- 1. Slowly increasing shoulder pain
- 2. Difficulty in sleep when lying on the affected shoulder
- 3. Restricted active movement
- 4. The most critical element is the loss of passive range of motion (ROM), which can be tested by a doctor or a physiotherapist
- 5. No abnormal findings can be seen on x-ray of the shoulder
Types of Frozen Shoulder
There are two types of frozen shoulder: Primary Frozen Shoulder and Secondary Frozen Shoulder.
Primary frozen shoulder is a stiffening of the shoulder joint that happens spontaneously without an obvious prior injury or damage. The cause has been uncertain, and this case is rarely seen in the clinics.
Secondary Frozen Shoulder, on the other hand, is stiffening of the shoulder joint after an injury or interrelated with a joint disease like osteoarthritis.
What Are The Common Preceding Event That Can Lead to a Secondary Frozen Shoulder?
Let’s say you had surgery on your shoulder, and you will have to refrain from moving the affected side. This immobilization post-surgery might induce a frozen shoulder.
Sports trauma can also cause the formation of a frozen shoulder. Basketball and tennis players, for example, may acquire a common injury called rotator cuff tear. People who do cleaning jobs are also prone to have this injury, which occurs from wear and tear, and repetition of similar motion over time.
Studies have shown an association between diabetes and frozen shoulder. According to a published article, about 20% of diabetic patients are at risk of having frozen shoulder due to changes in connective tissues secondary to elevated blood glucose.
Stroke can lead to immobilization of a part of the body. For example, an ischemic stroke results in loss of function of the body area such as weakness or complete loss of motor function of half of the body. The immobilization of the affected arm can result in a frozen shoulder.
Other conditions, such as cardiac disease, autoimmune disease, and even a few drug classes may lead to frozen shoulders. You need to consult your doctor for a proper diagnosis.
What Should Be Done to Your Frozen Shoulder?
Once your doctor has confirmed that you are having a frozen shoulder, you may be given a medication to relieve the pain. Some patients may need corticosteroid injections. The good news is that over 90% of patients improve without undergoing surgery.
An important nonsurgical treatment is a physiotherapy. It is actually the first-line treatment together with home exercise. Physiotherapy can help you to continue moving the shoulder and part of the therapy is to advise the patient with an exercise plan that is manageable to do at home with or without assistance.
According to a Medscape article by J. Roberts, M.D., shockwave therapy is comparable to oral steroids in terms of efficacy as a short-term treatment. Shockwave therapy was also suggested that it can be a safe alternative to steroid injections and surgical therapy for diabetic patients with frozen shoulder.
Frozen shoulder cases are seen every now and then in MN Physiotherapy Clinic, located at downtown Oshawa. We offer individualized treatment for this type of musculoskeletal problem, as we know that there can be an associated condition present as well. Aside from physiotherapy, we also offer shockwave therapy to patients who can benefit from it. For an immediate assessment by a registered physiotherapist, call us at (905) 571-1921 or book online via https://mnphysiotherapy.ca.