Frozen Shoulder: What is it and How to treat it?
A frozen shoulder, also known as adhesive capsulitis, is characterised by pain and stiffness in the shoulder joint that hinders its normal movement. It occurs more commonly between the ages of 40 and 60. According to statistics, women tend to suffer from a frozen shoulder more often than men. Usually, a frozen shoulder may take anywhere between 1 and 3 years to fully recover.
What is a Frozen Shoulder?
To better understand what happens during a frozen shoulder warrants a short lesson in basic human anatomy. Basically, the shoulder is made up of the ball and socket joint. It consists of the humerus (upper arm bone), clavicle (collar bone) and scapula (shoulder blade). Surrounding these three bones are connective tissues that bind the shoulder joint in a shoulder capsule along with synovial fluid that lubricate the shoulder joint. As the capsule becomes thick and tight, movement in the shoulder joint is hampered and this ultimately results in a frozen shoulder.
Essentially, a frozen shoulder has three stages:
Freezing Stage - Initially, pain starts to develop in the shoulder and the patient may experience limited movement. Overtime, the pain is known to heighten in intensity. The pain is usually severe at night and may cause discomfort.
Frozen Stage - During the second stage, while the pain may get dull, increased stiffness in the shoulder joint makes it difficult to move the shoulder and carry out day to day activities. During this period, mobility is seriously affected.
Thawing Stage - The final stage is when the shoulder starts to retain its usual mobility. This is the phase where stiffness begins to lessen and the shoulder returns to normal functionality.
According to WebMD, a frozen shoulder is usually said to occur in patients suffering from diabetes, Parkinsons, thyroid disorders such as hyperthyroidism and hypothyroidism, and heart disease. It is also reported in people who have undergone a mastectomy, stroke or recent physical injury or trauma.
With regard to physical injury or trauma, the primary cause contributing to a frozen shoulder is underuse of the shoulder following surgery, fracture or a long recovery period from any other injury. This immobilization of the shoulder results in stiffness and pain, leading to a frozen shoulder.
It is important to seek treatment for a frozen shoulder as soon as possible as the condition can worsen over time if left untreated. Additionally, once cured, it is possible for a frozen shoulder to occur again. However, in this case, it may be in the opposite shoulder.
How to treat a Frozen Shoulder?
Before treating a frozen shoulder, it is recommended that a patient should visit a medical practitioner in order to receive a conclusive diagnosis. The doctor may carry out a physical examination to ascertain the range of motion of the shoulder, and may even conduct X-ray or MRI testing to rule out any other possibilities. Secondly, it is advised that anyone suffering from a frozen shoulder should get a professional medical opinion for the best treatment options.
While some patients may prefer over the counter (OTC) pain relieving prescription medication, such as ibuprofen, naproxen or aspirin, others may gravitate towards alternative treatments to reduce pain, stiffness and inflammation as a result of a frozen shoulder. This is especially because overuse of painkillers may have side effects such as blood pressure issues and gastrointestinal problems that people want to avoid.
Below is a list of treatment options for those suffering with a frozen shoulder. Keep in mind that all these options will help manage the pain, and full recovery is expected to occur following routine treatment over an extended period.
Acupuncture, which is one of the most famous forms of alternative medicine, is a form of traditional chinese medicine (TCM) that has helped patients relieve pain symptoms and aided in their recovery. This treatment is especially recommended for those who want to avoid taking drugs and medicines for pain management during a frozen shoulder.
Acupuncture for frozen shoulder uses certain acupuncture points on the body to encourage the healing process and alleviate pain. Normally, it includes inserting needles at these specific points on the body. It is, however, a painless procedure. In fact, studies have shown that acupuncture is becoming increasingly sought after as a treatment for shoulder pain in general.
The acupuncturist may tailor the treatment to respond to each individual patient, which makes the entire procedure unique for every case. Typically, a patient may require somewhere between 6 to 10 sessions to mitigate the symptoms of a frozen shoulder.
Exercise, if performed correctly, is highly effective in treating a frozen shoulder. Stretching exercises for a frozen shoulder should be done daily to maximise its benefits. Ideally, it is helpful to warm up the area before beginning. This can be done by a hot shower or bath, a heating pad or a hot damp towel. This loosens the muscles and allows enhanced mobility.
Initially, movement of the shoulder may be restricted when exercising. But with continued exercise, the results are likely to surface fairly quickly and help reduce pain and stiffness.
It is recommended that such physical therapy be carried out by a certified physical therapist to help the patient ease into the exercise and teach him/her the correct way to avoid any further discomfort. Afterwards, the patient may exercise by themselves.
Stretching exercises such as towel stretch, pendulum stretch and crossover arm stretch will help in relieving pain. After mobility is improved over some time, it is helpful to follow through with strengthening exercises such as outward and inward rotation.
3. Hot or Cold Packs
Hot or cold packs are known to reduce inflammation and help in mobility when experiencing a frozen shoulder.
The use of either a hot or cold pack is dependant on the patient. A heating pad, hot towel or hot compress can be used. It is suggested that these rest on the shoulder for at least 20 minutes for the effects to be realised. Similarly, when using a cold pack, such as an ice pack, be sure to allow 5 minutes before concluding the treatment.
Hot or cold packs should be used 2 to 3 times a day or as needed.
4. Corticosteroid Injections
In extreme cases, if exercise or oral medication is not working, a corticosteroid injection may be recommended. Be mindful that this steroid injection has considerable side effects and should be carefully weighed against its risk factors for each individual patient.
A corticosteroid injection helps to reduce inflammation and consequently pain in the shoulder joint, which helps in enhanced mobility. While it doesn’t have lasting benefits, it can be used to temporarily alleviate pain – this can range from several weeks to four months.
A frozen shoulder is all about allowing motion in the shoulder joint to improve mobility. If the above treatments have not worked, there are additional procedures that may help minimize pain and stiffness.
Other treatments for frozen shoulder may include shoulder manipulation, joint distension and surgery as a last resort. These measures are recommended by doctors in cases where severe persistent pain is not getting dulled with any of the above suggested methods.
Additionally, maintaining a healthy nutrition may also impact a frozen shoulder. Having an anti-inflammatory diet is known to reduce stiffness and pain. Foods that help with inflammation include green vegetables such as spinach and kale, fruits such strawberries and oranges and fatty fish such as salmon and tuna. Similarly, it is best to avoid refined carbohydrates, red meat and sugary drinks.
Always remember, before embracing any treatment, be aware of the risks and always consult a medical doctor.