Frozen Shoulder Treatment Options

But what is a frozen shoulder, exactly?

Frozen shoulder, also known as adhesive capsulitis, is a common medical condition that causes pain, stiffness, and limited range of motion in the shoulder joint. The condition can lead to severe disability if left untreated and is more prevalent among women than men, primarily affecting those between 40 and 60 years old.

Although the exact cause of a frozen shoulder is not fully understood, it is believed to be associated with an inflammatory process, and it can also occur when the shoulder is immobilized for an extended period due to surgery, injury, or illness.

The shoulder joint is a complex mechanism that primarily operates on a ball-and-socket mechanism, connecting the humerus (upper arm bone) with the glenoid cavity of the scapula (shoulder blade). The joint's flexibility is supported by a network of ligaments, tendons, and bursae that cushion and stabilize the bones and muscles.

The rotator cuff, a group of muscles and tendons, controls shoulder movements. A flexible capsule surrounds the joint, which is filled with synovial fluid that provides lubrication and aids in smooth movement.

The shoulder's complexity of soft tissue structures contributes to its remarkable flexibility and increases the risk of trauma and wear and tear over time. To recover from frozen shoulder, it requires time and substantial self-help efforts.

It's important to seek medical advice and follow a comprehensive treatment plan that may include physical therapy, pain management, and stretching exercises to restore the shoulder's range of motion and reduce pain and stiffness.

How does a frozen shoulder happen?

The initial phase of the process commonly involves an injury, such as a fracture or inflammation of the soft tissues. Overuse injuries, including bursitis or tendonitis of the rotator cuff, are typically the underlying causes. Inflammation can result in pain that intensifies with movement and restricts the shoulder's mobility.

When the shoulder loses its ability to move, the connective tissue surrounding the joint, known as the joint capsule, thickens and contracts, which reduces its normal stretching capacity. Avoiding movement due to pain can lead to further contraction of the capsule, which can cause the humerus to have less space to move and the joint to lose its lubricating synovial fluid. Over time, adhesions can develop between the joint capsule and the head of the humerus, resulting in scar tissue formation.

The development of a frozen shoulder may take between two to nine months. Although the pain may gradually improve, stiffness persists, and the range of motion remains limited.

Who gets a frozen shoulder?

The likelihood of developing a frozen shoulder is heightened in cases where exercise therapy is not received following tendinitis or injury or if a sling is worn for an extended period without intermittent stretching.

Approximately 10% of individuals with rotator cuff disorders experience frozen shoulders. Additionally, enforced immobility due to a stroke, heart condition, or surgery can result in a frozen shoulder. Thyroid disorders and Parkinson's disease are further conditions that increase the risk of developing a frozen shoulder.

Frozen Shoulder Risk Factors

The etiology of frozen shoulder remains unknown. However, specific individuals are more susceptible to developing the condition due to certain risk factors, which include:

• Age: Frozen shoulder most commonly occurs in adults ages 40 to 60.
• Shoulder injury: Individuals who have recently undergone shoulder surgery, experienced a rotator cuff injury, or suffered a broken arm may be at a higher risk of developing a frozen shoulder.
• Diseases and other health conditions: Individuals diagnosed with diabetes, specific thyroid disorders, cardiovascular disease, Parkinson's disease, or those who have experienced a stroke may be at an increased risk of developing a frozen shoulder.

Effective Frozen Shoulder Treatment Options

Frozen shoulder can be quite a painful condition, but fortunately, there are various treatment options available. If you prefer to treat it at home, you may want to consider a few options. Here are some effective treatments that you can try in the comfort of your own home:

Rest Your Shoulder

During the frozen shoulder initial stage, the shoulder goes through a "freezing" phase, causing severe pain at night and rendering the joint stiff. The best way to manage something like frozen shoulders would be to take it easy by resting from repetitive motions. However, that should not mean one should immobilize their shoulder completely, since keeping them moving even a bit can help in the long run, rather than taking a more drastic measure that could impede their recovery process.

Heat & Cold Therapy for Shoulder Pain

A frozen shoulder is a common injury from seemingly any shoulder damage. In certain situations, it may be beneficial to use cold therapy pack, as this can constrict blood vessels and minimize swelling by numbing the area. But for soreness and pain caused by simple overuse, heat will ultimately be more soothing and beneficial for improving healing time.

Nursing an injury is difficult. The cold helps with the swelling and discomfort, but as you wait for it to go away, there are moments when you want to take all the pain away. This is why we recommend both herbal heating pads and cold therapy packs. While they bring great relief, it's important not to overdo it; after all, too much heat can lead to discoloration or bruising!

Use cold for the first three days after an injury, and then introduce heat. Bringing in the heat too soon can cause bruising or excessive swelling.

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Shoulder Stretches & Exercises

During the painful process of healing from a frozen shoulder, one should consider some stretching and exercises that will help restore the normal range of motion in the affected arm. Some specific range of motion exercises will work best in recovery, while a specific passive range of motion movements can be helpful and advisable.

Seemingly simple tasks like brushing your teeth or combing your hair become increasingly difficult with a frozen shoulder. Therefore, procrastinating on implementing these routine tasks could lead to missing other important aspects of life, such as a job interview or date with a significant other, if you're lucky enough to find one! So instead, start doing universal stretches for the shoulders regularly for about ten minutes three times a day.

Wearing a Shoulder Support

If a shoulder injury caused your frozen shoulder, like a rotator cuff tear, you should wear a sling or brace to support and immobilize your shoulder while it heals.

If you do not have any underlying shoulder injuries, we advise against using a shoulder brace. Wearing it might suggest you carry an injury you might not have, which could cause people to question it or even assume the worst.

Generally, when dealing with frozen shoulders, moving around is vital to stopping the progression of this condition and preventing your pain from worsening since movement speeds up blood circulation to the areas where tendons and ligaments attach to joints.

Medication

Many people deal with moderate to severe pain, and sometimes it can be challenging to overcome. The good news is that NSAID medications like ibuprofen or naproxen can help manage your pain and ensure you don't overwhelm yourself as you regain what you've lost through physical therapy. However, many medications have serious risks, so please speak with your physician before taking them.

Massage Relief

If you suffer from a frozen shoulder, massaging your muscles could be a great way to ease the stress that generally comes with it. Relaxing, self-massage tools are designed to make applying pressure easier and can be used on almost any body part. These tools can be extremely handy for people of all ages for back pain relief!

TENS Therapy

Like massage and acupuncture, a transcutaneous electrical nerve stimulation (TENS) unit is a small device that uses adhesive patches placed on the body to deliver a small electrical current. It isn't painful and is thought to relieve pain by interrupting the pain pathways or releasing endorphins, hormone-blocking painkillers, both fairly effective treatments.

For example, you can use the TENS unit on your upper arm and shoulder to relieve the pain related to a frozen shoulder - an excellent treatment where medication is not required. In addition, the TENS unit is easy to wear and versatile; you will want one for your home!

Professional and Medical Care

While some frozen shoulder treatments can be performed at home, you must see a healthcare professional to track what is happening. The most common symptom of a frozen shoulder is a pain in the shoulder region, and you should follow these steps for effective treatment.

Physical Therapy

To treat frozen shoulders, physical therapists rely on therapies and exercises. This can include muscle massaging, range of motion training (stretching), and ultrasound therapy. In addition to these therapies, you may be instructed in gentler exercises on the joints due to their reduced pressure and strengthening exercises for your neck, back, and arm muscles.

These treatments and other things, like over-the-counter pain meds for pain management, are essential for healing. Therefore, respect your physical therapist's medical advice by following their recommended treatment plan to expedite healing. It's important to keep your doctor updated about any changes in this condition, so don't skip out on sessions with your physical therapist!

Steroid Injection

Corticosteroid injections can provide some short-term relief from frozen shoulders. This method works best if used at the onset of the disease. The procedure is directly done by injecting cortisone medication into the shoulder joint. You must talk to your doctor to see if it suits you because it is not beneficial in every situation or outcome.

Hydrodilatation

Hydrodilatation is a process where high concentrations of salt and cortisone-based steroid medication are injected into the shoulder joint in fluid form. The salt is used to expand the joint, and the steroid is used to decrease swelling and pain. Radiologists with advanced imaging capabilities, who specialize in body MRI, use this procedure as an alternative therapy for people diagnosed with severe shoulder joint arthritis!

Surgeries

Surgery may be recommended when your condition has not improved significantly with other treatments. For example, suppose you have waited a year or more since starting the treatment. In that case, it is time to think about a solution that will permanently resolve your arm issues – rather than continuing to limp on only temporary treatments. There are two main approaches to shoulder surgery: arthroscopic and open shoulder manipulation.

Shoulder Arthroscopy

When a frozen shoulder strikes, you need more than a heating pad. Frozen shoulder is a condition that causes tissue to thicken around the shoulder, causing pain and a limited range of motion. As mentioned above, one solution is arthroscopic surgery to remove the extra tissue from the joint. The procedure involves using small incisions in the arm to insert a camera into the shoulder.

Closed Shoulder Manipulation

While some procedures may sound scary, this procedure has many positives. It can be done in an office without surgery and is often more cost-effective.

This procedure involves applying an anesthetic to put the patient to sleep. Then the doctor moves the shoulder in a certain way to stretch or tear the tight adhesions and scar tissue. This stretching is meant to improve your range of motion without surgery.

What are the signs and symptoms of a frozen shoulder?

Symptoms of a frozen shoulder are divided into three stages:

• The "freezing" stage:
• During this phase, the shoulder joint experiences a decrease in mobility and an increase in pain. The pain gradually intensifies and may be more severe during nighttime. Movement limitations in the shoulder area become more pronounced. This phase typically lasts from six weeks to nine months.
• The "frozen" stage:
• During this phase, patients may experience decreased pain; however, they continue to suffer from shoulder stiffness, resulting in a greater challenge when performing daily tasks and activities. This phase typically persists for a period of 2 to 6 months.
• The "thawing" (recovery) stage:
• During this stage, a reduction in pain is observed, and the ability to slowly move the shoulder improves. Finally, complete or nearly complete recovery occurs as normal strength and motion are restored. This stage can last from 6 months to 2 years.

How Long Does Frozen Shoulder Take to Heal?

In most cases, minor Frozen Shoulder can be effectively treated with physical therapy and home remedies. However, complete resolution of symptoms may take several months or even years. It's important to be patient and consistent with treatment to achieve the best results.

A word from Sacksy Thyme

Frozen shoulder, also known as adhesive capsulitis, is a condition that can cause stiffness and pain in the shoulder area. Although it can be treated at home, traction can be applied to offer some pain relief. Treatment involves a combination of heat therapy, stretching, and exercises that can ease tightness and relieve difficult symptoms.

However, it is important to consult with your doctor if you are experiencing a frozen shoulder, as full recovery will require medical care from a professional. Beginning treatment as soon as possible can help you on the journey back to recovery and better health.