What is Frozen Shoulder (Adhesive Capsulitis)? Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint, which significantly limits movement. It occurs when the connective tissue surrounding the shoulder joint becomes thickened and tight, forming adhesions and restricting the shoulder’s range of motion. This condition can develop gradually and often affects people between the ages of 40 and 60, with a higher prevalence in women.
Symptoms and Causes Symptoms typically include a progressive loss of shoulder mobility, pain that can be sharp or aching, and difficulty performing everyday tasks such as reaching overhead or behind the back. The condition usually progresses through three stages: freezing (painful), frozen (stiff), and thawing (recovery). The exact cause of frozen shoulder is not always clear, but it can be associated with certain factors such as diabetes, previous shoulder injury, or prolonged immobility.
Treatment Options
Medical Treatments:
- Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain and inflammation. Corticosteroid injections may be used for more severe pain to provide temporary relief.
- Hydrodilatation: This procedure involves injecting a saline solution into the shoulder joint to help stretch the capsule and improve mobility.
Role of Physiotherapy: Physiotherapy is essential in managing frozen shoulder and involves a range of strategies to alleviate symptoms and restore shoulder function. A comprehensive physiotherapy program may include:
- Range of Motion Exercises: Gentle stretching exercises to gradually improve shoulder mobility.
- Strengthening Exercises: Focused on the shoulder and surrounding muscles to support and stabilize the joint.
- Manual Therapy: Techniques such as joint mobilizations to enhance movement and reduce stiffness.
- Pain Management Techniques: Including modalities like heat or cold packs to manage pain and inflammation.
Advanced physiotherapy modalities may include:
- Shockwave Therapy: Uses acoustic waves to stimulate healing, reduce pain, and improve shoulder function.
- Laser Therapy: Employs focused light to reduce inflammation and promote tissue repair.
- Needling Techniques: Includes Dry Needling and Acupuncture:
- Dry Needling targets trigger points in the muscles to relieve pain and improve function.
- Acupuncture involves inserting needles at specific points to balance energy flow and alleviate pain.
Frequently Asked Questions (FAQs)
What are the early signs of frozen shoulder? Early signs include gradual onset of shoulder pain, stiffness, and difficulty with movements such as reaching overhead or behind your back. The pain may worsen over time, especially with movement.
How is frozen shoulder diagnosed? Diagnosis is typically made through a physical examination by a healthcare provider, assessing range of motion, pain levels, and shoulder function. Imaging tests, such as X-rays or an MRI, may be used to rule out other conditions and confirm the diagnosis.
What is the difference between frozen shoulder and rotator cuff injury? Frozen shoulder involves generalized stiffness and pain in the shoulder joint due to inflammation and thickening of the capsule. In contrast, rotator cuff injuries involve damage to the tendons of the rotator cuff muscles, leading to pain and weakness specifically related to shoulder movements. Physiotherapy can be effective for both conditions, but the treatment approaches may differ.
Can frozen shoulder heal on its own? Frozen shoulder can improve over time, but recovery can be slow and may take months to years without treatment. Physiotherapy is highly recommended to expedite recovery and restore shoulder function.
How long does it take to recover from frozen shoulder? Recovery time can vary widely. The condition typically progresses through stages over 1 to 3 years, with significant improvement often seen within 6 to 12 months with proper physiotherapy and treatment. The complete recovery may take longer, depending on the severity and response to treatment.
Will surgery be necessary for frozen shoulder? Surgery is generally considered a last resort for frozen shoulder, usually only if conservative treatments such as physiotherapy and injections are unsuccessful. Surgical options include shoulder arthroscopy to release the tight capsule.
Can I prevent frozen shoulder from recurring? Prevention includes maintaining good shoulder mobility and strength through regular exercise, avoiding prolonged immobility, and addressing any underlying health conditions that may contribute to frozen shoulder.
What should I avoid if I have frozen shoulder? Avoid activities that may exacerbate pain or stiffness, such as excessive shoulder movements or lifting heavy objects. Additionally, avoid immobility; it’s important to engage in gentle exercises and follow your physiotherapist’s recommendations to prevent worsening the condition.
When can I return to work or resume normal activities? The timeline for returning to work or resuming normal activities depends on the severity of your condition and the nature of your job. For less physically demanding tasks, return to work may be possible within a few months of starting physiotherapy. For jobs involving significant shoulder use, a longer recovery period may be necessary. Your physiotherapist will provide personalized guidance on when it’s safe to resume activities and how to modify them to prevent re-injury.
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