Understanding Frozen Shoulder: Causes, Symptoms and Diagnosis

Introduction

Shoulder pain can be a debilitating condition, impacting one’s ability to perform even the simplest of tasks. Among the various shoulder ailments, frozen shoulder stands out as a particularly painful and restrictive condition. Also known as adhesive capsulitis, frozen shoulder affects about 2% to 5% of the general population, most commonly individuals between 40 and 60 years old, and is more prevalent in women than in men.

What is Frozen Shoulder?

Frozen shoulder is characterized by pain and stiffness in the shoulder joint. It occurs when the connective tissue surrounding the shoulder joint, known as the shoulder capsule, becomes inflamed and thickened. This leads to the development of adhesions, which limit the shoulder’s range of motion, causing considerable pain and discomfort.

Causes of Frozen Shoulder:

While the exact cause of frozen shoulder is not always clear, several factors can contribute to its development:

1. Immobilization or Lack of Use:

One of the most common causes is prolonged immobilization of the shoulder joint, such as after surgery, injury, or illness. Lack of use can lead to the shoulder capsule thickening and contracting.

2. Inflammatory Conditions:

Conditions such as diabetes, hypothyroidism, and cardiovascular disease are often associated with an increased risk of developing frozen shoulder. The inflammatory response in these conditions can affect the shoulder joint.

3. Trauma or Injury:

A significant injury to the shoulder, such as a fracture or soft tissue injury, can lead to inflammation and subsequent development of adhesive capsulitis.

4. Autoimmune Disorders:

Certain autoimmune conditions, like rheumatoid arthritis, can cause inflammation in the shoulder joint, leading to frozen shoulder.

Symptoms of Frozen Shoulder:

The symptoms of frozen shoulder often develop gradually and typically progress through three stages:

Freezing Stage: In this initial stage, shoulder pain gradually increases, and range of motion begins to decrease. This stage can last from 6 weeks to 9 months.

Frozen Stage: The shoulder stiffness becomes more pronounced, limiting movement significantly. Daily activities such as combing hair, reaching for items, or even sleeping comfortably can become challenging. This stage can last from 4 to 6 months.

Thawing Stage: During this final stage, shoulder movement slowly begins to improve. Range of motion gradually returns, though this process can take anywhere from 6 months to 2 years.

Diagnosis of Frozen Shoulder:

Diagnosing frozen shoulder often involves a combination of physical examination, medical history review, and imaging tests. A doctor will typically:

1. Physical Examination: Your doctor will assess the range of motion in your shoulder, looking for areas of stiffness and pain.
2. Medical History: They will inquire about your symptoms, when they started, and any events or conditions that might have triggered them.
3. Imaging Tests: X-rays or MRI scans may be ordered to rule out other potential causes of shoulder pain, such as fractures or arthritis. These tests can also reveal the thickening of the shoulder capsule characteristic of frozen shoulder.

Treatment Options:

Treatment for frozen shoulder focuses on reducing pain and stiffness, and improving shoulder mobility. Options may include:

1. Chiropractic Treatment: Chiropractors are well-known for their expertise in spinal adjustments, but they can also perform adjustments on other joints, including the shoulder. These gentle, targeted manipulations aim to restore proper alignment and function to the shoulder joint. By mobilizing the joint and surrounding tissues, chiropractors seek to reduce stiffness and improve range of motion.
2. Physical Therapy: Gentle stretching and range of motion exercises prescribed by a physical therapist can help improve flexibility and reduce stiffness.
3. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections can help reduce pain and inflammation.
4. Shoulder Manipulation: In some cases, the doctor may manipulate the shoulder joint under anesthesia to help break up adhesions and improve range of motion.
5. Surgery: If other treatments have been unsuccessful, surgery to remove scar tissue and adhesions may be recommended.

Conclusion:

Frozen shoulder can be a painful and frustrating condition, impacting one’s daily life and activities. Recognizing the symptoms early and seeking prompt treatment can help manage the condition effectively. If you are experiencing persistent shoulder pain or stiffness, it is essential to consult with a healthcare professional for a proper diagnosis and personalized treatment plan. With the right approach, many individuals with frozen shoulder can regain full function and alleviate pain over time