Frozen shoulder, also known as adhesive capsulitis, is a condition in which the shoulder becomes stiff and painful. This usually happens after long periods of no motion- like when recovering from an injury or surgery. While anyone is subject to frozen shoulder, it is more likely in individuals between 40 and 60 years of age and diabetics.
Why does it Freeze?
The capsule that surrounds glenohumeral (shoulder) joint becomes inflamed, stiff, and painful. This makes it hard to move the joint and carry out basic arm motions. The symptoms may begin gradually and only present themselves at night, but these progress to daytime hours as the condition worsens. Although frozen shoulder may resolve itself over time, much can be done to speed up the process.
An injury to the shoulder (like rotator cuff tear) and close by structures like the clavicle pave the way for frozen shoulder. Individuals recovering from a stroke or major surgery are also at risk due to the limited shoulder movement. Frozen shoulder happens in three stages.
The Three Stages
Stage 1- The Freezing Stage. This is the first stage of frozen shoulder and symptoms progressively worsen. Stiffness and pain start in the late hours of the day and eventually day time- movement becomes limited.
Stage 2- The Frozen Stage. During this stage, the shoulder is the stiffest but pain may decrease. A person finds it hard to carry out basic shoulder motions such as shoulder flexion, extension, and abduction.
Stage 3- The Thawing Stage. In this stage the symptoms slowly begin to fade- pain lessens and movement improves. With the right exercises and techniques, the range of motion eventually returns to normal or close to normal.
While frozen shoulder can resolve itself, there are individuals who experience excruciating pain and symptoms only seem to worsen. In such cases, more sophisticated treatments may be taken- prolotherapy and manipulations techniques under local anesthetic are both options.
Treating Frozen Shoulder
Massage. Prevention is key when it comes to frozen shoulder. Finding ways to get movement is key in preventing motion restriction. Massage therapy, for example, will promote circulation and lymphatic drainage even when there is limited movement.
Corrective Exercise. Exercise keeps healthy joints, bones, and muscles. Corrective exercise can help regain use of the shoulder before and after it becomes stiff. after it has become stiff and before it stiffens. It will also help strengthen muscles, tendons, and ligaments that support the shoulder joint.
Manipulation Techniques- Manipulation techniques, both chiropractic and osteopathic, reduce swelling of the joint capsule, break adhesions, and help restore the mechanical function of the shoulder. Local anesthetic assists and makes the pain more manageable.
Prolotherapy- Injured soft tissues of the shoulder, including tendons and ligaments, can lead to pain shoulder movement and predispose frozen shoulder. By restoring supporting structures of the shoulder joint (there are many), prolotherapy helps restore the function of the shoulder joint and alleviate pain.
Alternative Treatments- Alternative treatments for frozen shoulder include acupuncture and transcutaneous electrical nerve stimulation (TENS). This helps spread the excess fluid of the joint capsule that is causing pain- the inflammation. Electrical stimulation keeps muscles strong even when movement is restricted by stimulating contraction.