Categories: Orthopaedics

Frozen shoulder

Frozen Shoulder is a condition that causes stiffness and pain in the shoulder joint. The situation is common among diabetic patients, and in people who keep their arm immobilised for a long time. In frozen shoulder, the shoulder capsule present in between the ball and socket joint of the arm becomes so thick and tight that it makes the shoulder tough to move. Thickening of the shoulder capsule takes more space and thus, less amount of synovial fluid is available to provide the lubricating property. It causes pain and obstructs the shoulder while moving the arms and we call it “frozen shoulder”. It is estimated to affect about 3 per cent of the population.

People with the age range of 40-60 are more likely to face the difficulty of frozen shoulder. It happens more often in women as compared to men. You have more chances to get a frozen shoulder if you are a diabetic patient and if you have other medical problems like heart disease, thyroid, or Parkinson’s syndrome. The risk of frozen shoulder increases if you’re recovering from a medical condition. Especially in those conditions which prevent you from moving your arm like a mastectomy. Anyone having stiffness in the shoulder joint should consult medical attention sooner rather than avoid permanent stiffness.

Causes of Frozen Shoulder:

The shoulder has a ball-and-socket joint filled with synovial fluid around the head of the upper arm. The bone fits into this socket most common cause of Frozen shoulder includes the following:-

  • The decrease in the synovial fluid concentration of the shoulder.
  • Fracture of the shoulder bone.
  • Low connective tissue supply in the capsule of the shoulder.
  • Stiff on the ball and socket joint.
  • The greatest outflow of synovial fluid.
  • Weakening of bones due to bone disorder.

Some other significant cause of frozen shoulder includes:

  • Age and sex – Mostly people above 40 and older age, particularly women, are more prone to have frozen shoulder.
  • Systemic diseases – People suffering from diseases like diabetes, hyper and hypothyroidism, tuberculosis, and cardiovascular disease are more likely to develop a frozen shoulder.
  • Immobility – Medical treatment of prolonged immobility are at more risk for developing a frozen shoulder. Some of the immobility shoulder diseases include rotator cuff injury and a broken arm.
  • Hormonal imbalance – Diabetes or a weakened immune system can cause joint inflammation. An immune deficiency causes damage and leads to a frozen shoulder and limits your range of motion for shoulder.

Sign and Symptoms of Frozen Shoulder:

Frozen shoulder develops slowly and lasts up to three stages. Each stage is lasting up to a few months.

  • Freezing stage: Where the movement of the shoulder causes pain, and the shoulder’s range of motion becomes limited.
  • Frozen stage: Pain goes on decreasing, but the shoulder becomes stiffer more challenging to move.
  • Thawing stage: The motion range of your shoulder begins to improve.

Treatment and Prevention for Frozen Shoulder:

  • Corticosteroid injection – It is administered in the shoulder joint to reduce your pain and improve your range of motion.
  • Surgery – It is very less prefer for frozen shoulder treatment, only if the patient perceives pain due to an accident or due to the development of infection.
  • Physical therapy – It is useful before certain phases of the frozen shoulder than others to get quick relief from shoulder stiffness.
  • Joint distension – In this method of treatment, the doctor injects sterile water into the shoulder capsule. It can help you move your shoulder more easily.
  • Shoulder manipulation – It helps in loosening of shoulder tissue but is decidedly less accomplish because of more chances to get bone fractures. Surgeons forcefully move the shoulder after injecting general anaesthesia.
  • Diagnosis – Magnetic resonance imaging scan (MRI) and X-ray methods are used to find out the cause of the frozen shoulder for the treatment.
  • Drugs – Using NSAID such as aspirin and ibuprofen (Advil, Motrin IB, others), can reduce the pain and inflammation due to frozen shoulder. Sometimes a doctor prescribes stronger analgesic and anti-inflammatory drugs for treatment.

Dr. Indranil Biswas, Consultant – Orthopaedics | Narayana Multispeciality Hospital, Barasat

Narayana Health

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