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Frozen Shoulder Syndrome: Causes and Treatment

“Frozen Shoulder” is the general medical description for a shoulder condition characterized by severely reduced range of motion.  Frozen shoulder, also known as adhesive capsulitis, is a condition that usually occurs in people over 40 years of age. If you suffer from diabetes, heart disease, connective tissue disorders or have had a stroke or a severe injury, then you are more at risk of contracting adhesive capsulitis.

What causes Frozen Shoulder Syndrome? Good question. The exact cause is unknown and there are several theories about its cause. Many physicians believe the causes are linked to myofascial trigger points associated with the muscles of the shoulder. As these trigger points cause greater and greater inflexibility in the muscles, the corresponding shoulder joint becomes locked into place over a series of months or even years.  Others believe frozen shoulder injuries are caused by inflammation of the joint lining which causes scar tissue to form around the joint. This scar tissue restricts movement in the shoulder causing it to ‘freeze’ and can be very painful. It’s also believed  incomplete healing of a previous shoulder injury can lead to frozen shoulder as the initial injury creates a buildup of scar tissue and inflammation in the shoulder joint.

The main symptoms are:

  • Decreased motion of the shoulder
  • Pain
  • Stiffness

Frozen Shoulder usually starts with pain. This pain prevents the patient from moving their arm. Lack of movement leads to stiffness and eventually less motion. Over time, you become unable to do movements such as reaching over your head or behind you.

After seeking medical advice, your physician may recommend conservative treatment options, meaning  rest, ice the injury, elevation of the injury and ingesting anti-inflammatory medication, and possible steroid injections.  Some studies have shown that steroid injections plus physical therapy can improve the patient’s motion.

In some cases, it may only take a few weeks to see progress, but in others, it may take as long as 6 – 9 months for complete recovery. Physical therapy is required in some cases and it can be intense, needing to be done every day.

Surgery is recommended if nonsurgical treatment is not effective. This procedure known as shoulder arthroscopy, is done under anesthesia. During surgery, the scar tissue is released by bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, the patient  may receive pain blocks so they can participate in physical therapy.

Prognosis

Treatment with physical therapy and nonsteroidal anti-inflammatory drugs will usually restore motion and function of the shoulder within 6 months. Even untreated, the shoulder can get better by itself in 6-12 months.

After surgery restores motion, patients must continue physical therapy for several weeks or months to prevent the frozen shoulder from returning. Treatment may fail if you cannot keep up with physical therapy. Surgery has the potential to speed recovery and improvement in range of motion.

Prevention

One of the most common causes of frozen shoulder is the immobility that may result during recovery from a shoulder injury, broken arm or a stroke. If you’ve had an injury that makes it difficult to move your shoulder, talk to your doctor about what exercises would be best to maintain the range of motion in your shoulder joint before it reaches the frozen shoulder stage.

If you haven’t had a recent shoulder injury and are still experiencing shoulder pain and stiffness that limits your range of motion for an extended period of time, once again contact your doctor for an evaluation.  Early treatment and physical therapy can lead to fewer complications and quicker recovery.

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This blog was written by Geoffrey S. Van Thiel, MD/ MBA, of Rockford Orthopedics Associates. Dr. Van Thiel specializes in Orthopedic Surgery – Sports Medicine.

Disclaimer: The opinions presented in this blog are provided for informational purposes only. The content is not meant to be complete or exhaustive or to be applicable to any specific individual’s medical condition. This blog should not be used to make a diagnosis or to replace or supplement your qualified health care professional’s judgment.

Rockford Orthopedic invites you to learn more about us and welcomes the opportunity to provide you with an exceptional experience by focusing on your individual orthopedic needs. Contact us at www.rockfordortho.com or 815-398-9491.

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