What Is Frozen Shoulder?
Frozen shoulder, or adhesive capsulitis, is a painful and debilitating condition in which the connective tissue surrounding the shoulder joint stiffens and restricts normal range of motion. The majority of people who develop this condition are aged between 40-70 years. It occurs in women more often than men and 3% of people will develop frozen shoulder at some point in their lifetime.
The shoulder is a ball and socket joint comprised of three bones; the upper arm (humerus), the collar bone (clavicle) and the shoulder blade (scapula). The top of the humerus fits into a depression on the outside of the scapula. Connective tissue surrounding the joint forms the capsule. Synovial fluid acts as lubrication inside the shoulder joint and allows the shoulder to move more freely.
How Does Frozen Shoulder Occur?
Any shoulder problem that would cause somebody to stop using the shoulder joint normally can result in frozen shoulder. Frozen shoulder more typically occurs in individuals who recently sustained an injury to the shoulder, have undergone surgery to the shoulder or suffer from chronic disease such as diabetes and arthritis.
So What Happens?
Inflammation as a result of chronic condition, injury or surgery to the shoulder causes pain and reduced movement of the shoulder. The connective tissue surrounding the shoulder joint stiffens and thickens and causes the capsule to tighten. Taut, painful bands of soft tissue called adhesions form. The shoulder “Freezes” because pain prevents movement. A typical person with frozen shoulder can not move their shoulder on their own or with help from someone else.
Three Stages of Frozen Shoulder
There are three stages of frozen shoulder that occur over time.
1. Freezing-Increased pain over time leads to decreased range of motion. Can last anywhere from 6 weeks to 9 months.
2. Frozen-Stiffness and range of motion worsens. Pain usually subsides during this stage. Can last 4-6 months and is extremely debilitating.
3. Thawing-Range of motion slowly returns and stiffness subsides. Without appropriate treatment can last for several years.
How Is Frozen Shoulder Diagnosed?
After taking a thorough history, the doctor will conduct a functional examination of the shoulder. Severely reduced range of motion of the shoulder during physical examination with or without pain are objective findings consistent with the diagnosis of frozen shoulder. X-ray may be prescribed to rule out infection, fracture or any other acute processes.
Effective Treatment of Frozen Shoulder
The main goal in treating frozen shoulder is to reduce pain first if pain still presents, loosen tight connective tissue and restore range of motion. Ice, cold laser and ultrasound are modalities that can be used to decrease pain. Active Release Techniques is a soft tissue technique that is effective in removing adhesions and loosening tight tissue. Therapeutic exercises help restore range of motion and strength in the shoulder region.