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Frozen Shoulder

Anatomy Frozen Shoulder | Orchard Health Clinic

What is Frozen Shoulder?

Frozen Shoulder or Adhesive Capsulitis is a common disorder that causes pain, stiffness, and loss of normal range of motion in the shoulder. There are 3 stages to Frozen Shoulder.

Diagnosing Frozen Shoulder

Here’s a comprehensive guide to understanding how healthcare professionals diagnose frozen shoulder:

  1. Clinical Assessment: During the evaluation, the healthcare professional will review your medical history, inquire about symptoms, and conduct a thorough physical examination of your shoulder joint.
  2. Range of Motion Testing: This involves assessing your ability to move the affected shoulder in various directions, noting any limitations, stiffness, or pain during movement. Restricted range of motion, particularly in outward rotation and abduction, is a hallmark feature of frozen shoulder.
  3. Pain Assessment: Patients with frozen shoulder typically report pain that worsens with movement and may radiate down the arm. The healthcare provider will inquire about the onset, duration of your discomfort, and factors associated with the pain.
  4. Diagnostic Imaging: While not always necessary, diagnostic imaging studies such as X-rays, ultrasound, or magnetic resonance imaging (MRI) may be ordered to further evaluate your shoulder joint and rule out other potential causes of symptoms before commencing frozen shoulder treatment.

Understanding the Risk Factors of Frozen Shoulder

Several risk factors predispose individuals to this condition and some of these include:

  1. Prolonged Immobility: Extended periods of shoulder immobility, whether due to post-surgical recovery, arm fracture, or prolonged inactivity, significantly increase the risk of developing frozen shoulder. The lack of movement allows the shoulder capsule to tighten and constrict, laying the groundwork for frozen shoulder.
  2. Underlying Medical Conditions: Certain medical conditions, such as diabetes mellitus, thyroid disorders, cardiovascular disease, and autoimmune conditions, heighten susceptibility to frozen shoulder. These conditions may disrupt normal joint function and contribute to inflammation and thickening within the shoulder capsule.
  3. Age and Gender Factors: Frozen shoulder tends to affect individuals aged 40 and above more commonly, with women, especially those going through menopause, being at a higher risk. Hormonal changes and age-related alterations in connective tissue metabolism may contribute to this increased susceptibility.
  4. Trauma or Injury: Traumatic incidents, such as falls or impacts to the shoulder region, can put you at higher risk of frozen shoulder. The resulting inflammation and tissue damage may lead to the formation of scar tissue within the shoulder joint, exacerbating stiffness and restricted mobility.

Recognising these risk factors is essential to help you identify if you are at heightened risk of developing frozen shoulder. This allows you to implement preventive measures and early interventions such as frozen shoulder treatment in Singapore.

Causes of Frozen Shoulder

Frozen shoulder arises when the connective tissue capsule surrounding the shoulder joint thickens and tightens, limiting movement. While the exact cause remains uncertain, prolonged shoulder immobility, such as after surgery or an arm fracture, is a common trigger. Factors like genetic predispositions or underlying medical conditions may also play a role. Traumatic incidents can also further exacerbate the condition.

Stages of Frozen Shoulder

Stage 1 Freezing:

In the “freezing” stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.

Stage 2 Frozen:

Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.

Stage 3 Thawing:

Shoulder motion slowly improves during the “thawing” stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

Understanding the Symptoms of Frozen Shoulder

  • Gradual Onset of Pain: One of the earliest signs of frozen shoulder is the gradual onset of pain which may begin mildly, often worsening over time and becoming more pronounced, particularly during movement or at rest.
  • Stiffness and Reduced Mobility: As the condition progresses, you may notice a significant reduction in shoulder mobility, accompanied by stiffness and tightness in the joint. Simple tasks such as reaching overhead, lifting objects, or even dressing yourself may become increasingly challenging.
  • Difficulty Sleeping on Affected Side: You may experience difficulty sleeping on the affected side due to discomfort and restricted movement. The pain and stiffness may intensify at night, further disrupting sleep patterns and contributing to fatigue and irritability.
  • Limited Range of Motion: You may find it challenging to perform overhead movements, rotate the arm outward or inward, or lift the arm away from the body.

If you are experiencing any of these symptoms, consult a healthcare professional for an accurate diagnosis and personalised frozen shoulder treatment plan in Singapore tailored to your needs.

Frozen Shoulder Treatment

Physical therapy can help with Frozen Shoulder pain. The overall goal of physical therapy is to restore movement. Once the evaluation process has identified the stage of the condition, a physical therapist will create an individualized exercise program tailored to specific needs. Exercise has been found to be most effective for those who are in stage 2 or higher.

In stages 1 and 2, exercises and manual therapy techniques will help maintain as much range of motion as possible and reduce pain. Modalities such as heat and ice treatments will also be to help relax the muscles prior to other forms of treatment. A gentle home-exercise program will be designed to help reduce the loss of motion when there is progress and safe healing.

The focus of treatment during stage 3 is on the return of motion. Treatment may include the introduction of more intense stretching techniques to encourage greater movement and flexibility, manual therapy to a higher level to encourage the muscles and tissues to loosen up, and strengthening exercises targeting the shoulder area as well as core muscles.

In the final stage, the therapist will focus on the return of normal shoulder body mechanics and functional training. The focus of treatment includes manual therapy, stretching, and range of motion exercises for the shoulder. Exercise has been found to be most effective for those who are in stage 2 or higher. Sometimes heat therapy is used to help loosen the shoulder up before treatment. As treatment progresses, functional training will be incorporated and a home-exercise program will be designed to help reduce loss of motion as well as promote safe healing. If in doubt, please seek professional advice.

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