shoulder pain treatment

Frozen Shoulder (Adhesive Capsulitis)

Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder is a condition that affects your shoulder joint. It usually involves pain and stiffness that develops gradually, gets worse and then finally goes away. This can take anywhere from a year to 3 years.

Symptoms

The main symptoms of a frozen shoulder are pain and stiffness that make it difficult or impossible to move it.

If you have frozen shoulder, you’ll likely feel a dull or achy pain in one shoulder. You might also feel the pain in the shoulder muscles that wrap around the top of your arm. You might feel the same sensation in your upper arm. Your pain could get worse at night, which can make it hard to sleep.

You’ll typically go through three phases with a frozen shoulder. Each has its own unique symptoms and timeline.

Freezing stage:You develop a pain (sometimes severe) in your shoulder any time you move it.
It slowly gets worse over time and may hurt more at night.
This can last anywhere from 6 to 9 months.
You’re limited in how far you can move your shoulder.

Frozen stage:

Your pain might get better but your stiffness gets worse.
Moving your shoulder becomes more difficult and it becomes harder to get through daily activities.
This stage can last 4-12 months.

Thawing stage:

Your range of motion starts to go back to normal.
This can take anywhere from 6 months to 2 years.

 

  • Causes

    Frozen shoulder happens more often in women than men, and you’re more likely to get it if you’re between the ages of 40 and 60. Your risk might also go up if you’re in the process of recovering from a medical condition like a stroke, or surgery like a mastectomy that keeps you from moving your arm.

    Certain medical conditions can increase your risk too. You may also be more likely to get frozen shoulder if you have diabetes. About 10% to 20% of people with diabetes get frozen shoulder. Other medical problems like heart disease, thyroid disease, or Parkinson’s disease are linked to frozen shoulder, too.

  • Prevention

    One of the most common causes of frozen shoulder is the immobility that may result during recovery from a shoulder injury, broken arm or a stroke. If you’ve had an injury that makes it difficult to move your shoulder, talk to your doctor about exercises you can do to maintain the range of motion in your shoulder joint.

    During the physical exam, your doctor may ask you to move in certain ways to check for pain and evaluate your range of motion (active range of motion). Your doctor might then ask you to relax your muscles while he or she moves your arm (passive range of motion). Frozen shoulder affects both active and passive range of motion.

    In some cases, your doctor might inject your shoulder with a numbing medicine (anesthetic) to determine your passive and active range of motion.
    Frozen shoulder can usually be diagnosed from signs and symptoms alone. But your doctor may suggest imaging tests — such as X-rays or an MRI — to rule out other problems.

  • Treatment

    Shoulder exercises
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    Most frozen shoulder treatment involves controlling shoulder pain and preserving as much range of motion in the shoulder as possible.

  • Medications

    Over-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin IB, others), can help reduce pain and inflammation associated with frozen shoulder. In some cases, your doctor may prescribe stronger pain-relieving and anti-inflammatory drugs.

  • Therapy

    A physical therapist can teach you range-of-motion exercises to help recover as much mobility in your shoulder as possible. Your commitment to doing these exercises is important to optimize recovery of your mobility.

  • Surgical and other procedures

    Most frozen shoulders get better on their own within 12 to 18 months. For persistent symptoms, your doctor may suggest:

    Steroid injections.

    Injecting corticosteroids into your shoulder joint may help decrease pain and improve shoulder mobility, especially in the early stages of the process.

    Joint distension.

    Injecting sterile water into the joint capsule can help stretch the tissue and make it easier to move the joint.

    Shoulder manipulation.

    In this procedure, you receive a general anesthetic, so you’ll be unconscious and feel no pain. Then the doctor moves your shoulder joint in different directions, to help loosen the tightened tissue.

    Surgery.

    Surgery for frozen shoulder is rare, but if nothing else has helped, your doctor may recommend surgery to remove scar tissue and adhesions from inside your shoulder joint. Doctors usually perform this surgery with lighted, tubular instruments inserted through small incisions around your joint (arthroscopically).

  • Lifestyle and home remedies

    Continue to use the involved shoulder and extremity as much as possible given your pain and range-of-motion limits. Applying heat or cold to your shoulder can help relieve pain.

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