FROZEN SHOULDER

When Alka Sharma, 51, developed a pain in her shoulder, she assumed she had been "sleeping on it wrong." When the pain didn't go away and her shoulder got so stiff she couldn't comb the back of her hair, she worried she might be developing arthritis.


It wasn't arthritis. Instead, Alka had developed a classic case of frozen shoulder — an excruciating pain, lost movement and, usually, a months-long recovery.




WHAT IS FROZEN SHOULDER??



A frozen shoulder is a shoulder that has become so stiff that the patient usually cannot lift their arm up past shoulder height, cannot put hand in back pocket or tuck in their shirt and has difficulty reaching across under the other arm (i.e. washing the opposite arm pit), Severe night pain and waking Inability to lie on your side at night.
The exact degree of shoulder stiffness present may be variable but in order for a shoulder to be classified as truly frozen there must be significant movement loss.

Clinically Frozen shoulder is also called Adhesive Capsulitis.When the connective tissue called the shoulder capsule becomes inflamed and stiff, it can cause pain and loss of movement.The shoulder capsule should not be confused with the rotator cuff which is made of muscles.




WHAT IS THE CAUSE



It can be of two types

1. primary or idiopathic - where there is no cause known.

2. Secondary - this is possible
*Trauma
*diabetes- Diabetics are more likely to suffer because it is thought that raised blood glucose levels make connective tissues thicker and more sticky, so more likely to adhere to bones.
* Immobilization of shoulder
* cervical spondylosis
* thyroid hormone imbalance
* old age possibly because of inflammation in the ligament and other soft tissues with the age related degeneration.




STAGES OF FROZEN SHOULDER



•Stage 1: The shoulder hurts, especially at night, and the pain worsens with time. "These patients do not sleep," This lasts up to three months. In the first stage, inflammation in the lining tissue triggers the growth of scar tissue.



•Stage 2: The pain continues and the shoulder stiffens; overhead movements are tough or impossible. This can last up to nine months.In the second phase, the sticky joint lining starts bonding to the bones in the joint, forming what are known as adhesions.




•Stage 3: The pain is gone, but the stiffness remains until a gradual thaw sets in. This can last up to 13 month .In the final "thawing" phase, the shoulder gradually regains movement.



PHYSIOTHERAPY TREATMENT FOR FROZEN SHOULDER



Electric Modalities like ultrasound /IFT / SWD can be used to reduce pain and inflammation.

Mobilisation to reduce stiffness and improve range of motion.

Exercises - stretching to improve flexibility , strengthening to improve the strength of shoulder muscles. swinging exercises or pendulum exercise to increase range of motion.Home exercise programme to get an optimal result.