Frozen Shoulder: Causes, Treatment and Exercise
Do you experience stiffness and pain while moving your shoulder? You might be suffering from a Frozen Shoulder?
Frozen shoulder or Adhesive Capsulitis is a condition that can cause stiffness and pain in the shoulder joint.
It is important to note that it can worsen over time. Thus, one should seek medical advice immediately.
Keep on reading to learn more about frozen shoulder.
A frozen shoulder can cause stiffness and pain in your arm and shoulder i.e. shoulder joint. Moreover, the signs and symptoms usually begin gradually, however, they tend to get worse with time.
It usually takes about 1 to 3 years for it to get worse.
Thus, if you are recovering from a medical condition that does not involve you moving your upper arm, then you are at risk of developing this condition.
Frozen shoulder can also result from a certain procedure that prevents you from moving your arm entirely.
These procedures are stroke and mastectomy.
You can opt for different treatment options ranging from exercises at home to sometimes using corticosteroids and numbing medications in case of excessive pain.
However, in some cases, you may need arthroscopic surgery to treat this condition.
This indicates that via surgery, your doctor will loosen the joint capsule so that it can move easily.
It is often unusual for the frozen shoulder to recur, however, you may experience it in the opposite shoulder joint.
Let’s learn about the causes and symptoms of Frozen Shoulder.
Causes and Symptoms of Frozen Shoulder
It is important to note that a frozen shoulder does not develop suddenly, rather it develops gradually and takes 1 to 3 years to causes extreme pain.
It often causes immobility or stiffness of your shoulder thus, reducing the movement of your arm.
Moreover, it can also occur if you are suffering from certain conditions.
Keep on reading to learn more about it.
Causes of Frozen Shoulder
Your shoulder joint consists of bones, ligaments, and tendons.
These are all encased in a capsule of the connective tissues in the shoulder joint.
If a frozen shoulder occurs, this capsule thickens and tightens around the shoulder joint, thus, restricting the movement of your shoulder and arm.
Moreover, doctors do not know the exact cause of a frozen shoulder.
However, they are of the view that it is more likely to occur if you have type 1 or type 2 diabetes.
It is important to note that a frozen shoulder can also restain the movement of your shoulder joint if you had to immobilize it for a long period of time.
Such conditions are often after a surgery or an arm fracture.
Thus, due to restricted movement of your upper arm and shoulder due to any injury, can also lead to a frozen shoulder.
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Immobility and Systemic Diseases
In case of prolonged immobility or reduction in movement of your shoulder, you are more likely at a higher risk of developing a frozen shoulder.
This immobility can be due to a number of reasons.
They can be due to rotator cuff surgery, broken arm, stroke, or recovery from surgery.
However, if you are suffering from systemic diseases, then you are more prone to suffering from a frozen shoulder.
Certain medical disorders can increase your risk of developing this condition. These are:
- overactive thyroid or hyperthyroidism
- underactive thyroid or hypothyroidism
- cardiovascular diseases
- tuberculosis, TB
- Parkinson’s disease
The above conditions can increase your chances of developing a frozen shoulder.
Symptoms of Frozen Shoulder
A frozen shoulder typically develops within 1 to 3 years and in 3 different stages.
Each one of these stages may last for a number of months and are as follows:
In this stage, any movement can cause pain and the range of your motion of the shoulder starts to become limited.
During this stage, pain main begins to diminish or reduce.
However, your shoulder can become stiffer and it can become difficult to use it.
At this stage, the range of motion in your shoulder begins to move.
In some cases, the pain may worsen at night, and can even disrupt sleep in some situations.
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Treatment and Exercises
Diagnosing a frozen shoulder involves moving your shoulder in different motions and in certain ways. Depending on the diagnosis, your doctor will determine your treatment plan and it can range from using medications to sometimes surgery.
Moreover, with the help of certain exercises, you can also relieve a frozen shoulder, however, you should always consult a physiotherapist or doctor and ask them first.
Diagnosing Frozen Shoulder
While visiting a physiotherapist or a doctor, they will first conduct a physical examination.
During this, they will ask you certain questions related to the movement of your arm and shoulder.
Moreover, they will also ask you to move your arms and shoulder in certain ways.
This helps them to check for pain and evaluate the range of motions or active range of motions.
They will then ask you to relax your shoulder muscles while they move your arm or passive range of motion for your shoulder and arm.
For the diagnosis of frozen shoulder, evaluation of both active and passive range of motion is important.
However, in some cases, your doctor may also order image testing like an X-ray, or an MRI scan to rule out the possibility of other conditions.
In some cases, your doctor may also inject a numbing medication into your shoulder or anesthesia to determine the active and passive range of motion.
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Treating Frozen Shoulder
You can leave your frozen shoulder untreated, however, in case it causes stiffness and pain, for more than 3 months, you should get treatment.
A combination of physical therapy, medication, surgery, and home care can help speed up your recovery.
Let’s discuss them as follows:
The most common treatment for a frozen shoulder is physical therapy.
The goal of this therapy is to stretch your shoulder point and regain the lost motion.
However, it can take at least 9 months to see progress. Moreover, certain home exercises can also help.
But if you do not see any progress after 6 months, consult your doctor about other options.
Your doctor may prescribe anti-inflammatory medications to treat pain and reduce inflammation in the shoulder joint.
These are aspirin, ibuprofen, or naproxen sodium. However, in some cases, a steroid injection into the shoulder joint can also help.
Taking Care of a Frozen Shoulder at Home
You can also take care of a frozen shoulder at home by placing an ice pack for at least 15 minutes on your shoulder at a time. This helps to decrease the pain.
If you are already working with a physical therapist, they will provide some instructions on how you can perform certain exercises at home.
They will guide you about the repetition and how often you should do them at home.
For most individuals, a frozen shoulder improves without surgery, however, you may need one if none of the above treatments are improving the condition.
When exercises and physical therapy are not helping with the movement of your shoulder, your docotr will advise you to opt for surgery.
From a surgical viewpoint, the option is to manipulate your shoulder and put it through a full range of motions under general anesthesia,
Another surgical option is Arthroscopic Surgery. This includes making small cuts or incisions into your shoulder.
With the help of a small camera, or Arthroscope, the doctor or surgeon will remove the scar tissue or release it.
This surgery allows your shoulder to recover its lost range of motion.
It is important to note that if this condition occurs due to an injury, surgery is usually successful and is often the case when your doctor performs it in a few weeks of injury.
Your surgeon will carry out this procedure on an outpatient basis and will remove the stitches after 10 days when the wounds heal.
After the procedure, however, your doctor will recommend post-operative physical therapy.
You will have a full range of motion back in 3 months.
However, surgeries carry risks, thus, it is important to discuss all the aspects of the surgery before deciding on the procedure.
Exercises to relieve Stiffness
Certain at-home exercises can help you to treat frozen shoulder at home, however, make sure to consult your doctor or physiotherapist first.
It is important to go slow in the first and most painful stage of a frozen shoulder, and you can increase in intensity gradually.
According to different studies, if you exercise within the limits of the pain, you can reach near-normal painless motion of the shoulder within 13 months by 64% and 89% by 24 months of exercise.
These studies compare the results of individuals who are receiving intense physical therapy by 63% reaching near-normal pain shoulder.
Let’s discuss some of these exercises.
Behind the Back Stretch
Follow the instructions carefully as stated below:
Stand with your legs shoulder-width apart and put your affected arm behind your back.
In this position, with the help of your other arm, gently push the palm of the affected arm in upward motions, towards the opposite shoulder.
Hold this stretch for 1 to 5 seconds and stop when you feel pain.
It is important to repeat this stretch at least 2 to 3 times a day.
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Abduction means to move the arm away from the midline of your body.
For this exercise, sit next to a table, while resting your affected arm and elbow on the surface of the table.
Slowly slide your forearm away from the body and stop when you begin to feel pangs of pain.
Your body may tilt or move with this motion, but, do not let your body lean on the table.
Repeat this exercise at least 2 to 3 times a day.
External Rotation Door Stretch
To perform this exercise, follow the instructions:
Stand in the door fare with the elbow of your affected arm best at a 90-degree angle and rest your palm and wrist against the frame of the door.
While keeping your forearm in one place, slowly turn your body away from the door frame.
Stop this stretch when you begin to feel pain and repeat this stretch at least 2 to 3 times.
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A frozen shoulder often can result in restricting the motion of your shoulder arm and excess pain, however, with the help of physical therapy, routine stretching, and exercises, you can reduce the pain and stiffness in both the short and long term.
Moreover, these can help you to regain the motion in the frozen shoulder, however, always seek medical advice before trying any exercise.
Your doctor may advise you of an exercise program along with a combination of medications like NSAIDs, pain relief medications, and corticosteroids, hydrodilatation, or hyaluronan injections to treat frozen shoulder.