Frozen Shoulder ‘Busting the Myths’

1. What happens when someone gets a frozen shoulder?

Frozen shoulder, also known as Adhesive Capsulitis is a condition characterized by varying degrees of pain and stiffness in the shoulder joint.  The tissues in your shoulder get thicker and tighter leading to scar tissue. As a result your shoulder joint doesn’t have enough space to rotate freely.

2. What are the symptoms one should look out for and when should one see a doctor?

A person with frozen shoulder will have a persistently painful and stiff shoulder joint.

This may seriously interfere with his ability to do everyday tasks such as dress and bathe, or even work. Even when the pain starts to improve, the stiffness can be quite disabling. This condition might impede you from reaching overhead, to the side, across your chest, or from rotating your arm all the way around from front to back. This could make it impossible for you to scratch your back or put on your vests/bra.

3. What are the causes of frozen shoulder?

The shoulder is the only joint that commonly freezes like this.
The bones, ligaments and tendons that make up the shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint restricting its movement. This biological puzzle is yet to be unraveled, meaning the exact cause of the freezing remains a mystery till date.

4. Who is more at risk of developing it?

  • It commonly affects middle aged people between the ages of 40-60 especially women.
  • People who wear a shoulder sling for prolonged periods following trivial trauma or surgery.
  • Diabetics are at an higher risk with nearly 20% of them getting afflicted by it.
  • Certain other medical conditions such as underactive Thyroid, Stroke and Parkinson disease have known to cause frozen shoulder.

5. What are the treatment options?

  • Physiotherapy- This is the most common mode of treatment. The goal is to stretch your shoulder joint and recover motion. This can take anywhere from few weeks to few months.
  • Medications – Your treating doctor can prescribe medications to decrease pain and reduce inflammation in the joint. A corticosteroid injection into your shoulder joint has shown to offer good pain relief and assist in the physiotherapy.
  • Surgery – If physical therapy doesn’t improve your condition, surgery is an option. Surgical options are to manipulate the shoulder and put it through a full range of motion under a general anesthetic to help break up any adhesions. A newer and more advanced technique is arthroscopic surgery. This type of surgery involves making a small cut in your shoulder and using a camera called an “arthroscope” to remove scar tissue or release it. This allows the shoulder to recover its lost motion.

6. Can this condition be prevented?

If you don’t put shoulder complex through a wide range of motion on a regular basis through everyday activities and exercise, the ligaments and tendons in this area won’t receive an optimal supply of blood for nourishment and removal of waste products. Over time, lack of optimal blood circulation to these ligaments and tendons can cause them to tighten up. Regular stretching of the shoulder joint and strengthening of the muscles around your shoulder can greatly reduce the chances of developing a frozen shoulder in later life.

Tips to keep the frozen shoulder away :

If you are desk bound for several hours a day, take frequent breaks. This could be a short five minute break every one and half hours. Also, maintain a good posture. the head should be up and the shoulder slightly back. Ask for a chair and workstation with good ergonomics. Including reliable sources of Vitamin D and friendly bacteria in your diet can significantly strengthen the immune system and decrease the risk of developing conditions such as frozen shoulder which have an autoimmune component.

7. Are there activities that people with a frozen shoulder should avoid?

Frozen shoulder is not a repetitive strain /overuse injury, in fact as previously stated it is frequently brought on by a period of immobilization.

Your treating doctor will routinely ask for X rays and Ultrasound / MRI scans to rule out other concomitant conditions such as Shoulder Arthritis, Rotator cuff tears in the shoulder. Provided your scans are negative, there is no restriction of activities for a person with frozen shoulder.

8. What happens when a frozen shoulder is left untreated?

If untreated, the tissues in the shoulder can further tighten leading to varying degrees of permanent stiffness and residual disability in the shoulder joint.

9. Are there any home remedies that help?

Placing an ice pack on your shoulder for 15 minutes at a time several times per day can help to decrease pain. If you’re working with a physical therapist, the exercises can be done at home. Your physical therapist will provide instructions on the types of exercises you must do, how often to do them, and when to push yourself harder.

10. Is there anything else you’d like to add?

Once thought to be a self limiting condition, frozen shoulder is becoming a chronic and  difficult condition to overcome with the current stress induced urban lifestyle.  The key to unlocking this mystery is early diagnosis and timely intervention by your doctor preferably a shoulder specialist.