Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition that affects the shoulder joint, leading to pain, stiffness, and limited range of motion. It typically develops gradually and worsens over time, causing significant discomfort and functional impairment.

Causes

The exact cause of the frozen shoulder is still unclear, but several factors can contribute to its development. It commonly occurs following a period of shoulder immobilisation, such as after surgery, injury, or prolonged immobilisation due to a medical condition. Other risk factors include age (more common in individuals over 40), gender (women are more prone to develop it), certain medical conditions (diabetes, thyroid disorders, cardiovascular disease), and hormonal imbalances.

Symptoms

The primary symptom of frozen shoulder is pain, which is often dull, aching, and worsens with movement. The pain usually starts gradually and becomes more persistent over time. Stiffness is another hallmark symptom, with the shoulder joint becoming increasingly difficult to move. This can lead to functional limitations, making it challenging to perform daily activities like reaching overhead, dressing, or combing hair. The range of motion in the shoulder is significantly reduced, and there may be a noticeable loss of strength.

Stages of Frozen Shoulder

Frozen shoulder typically progresses through three stages, each characterised by distinct symptoms:

• Freezing Stage - This stage involves the onset of pain and increasing shoulder stiffness. Range of motion begins to decrease, and the shoulder becomes progressively more difficult to move.
• Frozen Stage - During this stage, pain may lessen, but the stiffness becomes more pronounced. The shoulder is significantly restricted in movement, causing considerable functional limitations.
• Thawing Stage - In this final stage, the range of motion gradually improves, and shoulder function begins to return. Pain and stiffness diminish, but it may take several months to years to regain full mobility.

Diagnosis

To diagnose frozen shoulder, Dr Rajesh Malhotra will conduct a thorough evaluation of the patient's medical history and perform a physical examination. During the examination, he will assess the shoulder's range of motion, looking for signs of stiffness and pain. Imaging tests like X-rays or magnetic resonance imaging (MRI) may be ordered to rule out other conditions or detect any underlying structural issues.

Frozen Shoulder Treatment

The treatment for frozen shoulder aims to relieve pain, restore shoulder mobility, and improve overall function. It often involves a combination of non-surgical interventions and, in rare cases, surgical procedures. Here are some common treatment options:

• Pain Relief - Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) or prescription pain medications may be prescribed to alleviate pain and inflammation.
• Physical Therapy - Dr Rajesh Malhotra may recommend consulting a physical therapist who can guide patients through stretching and strengthening exercises to improve range of motion and shoulder function. Heat or cold therapy, ultrasound, and transcutaneous electrical nerve stimulation (TENS) may also be used to relieve pain and stiffness.
• Corticosteroid Injections - Injecting corticosteroids into the shoulder joint can help reduce inflammation and pain, facilitating better movement.
• Hydrodilatation - This procedure involves injecting sterile fluid into the shoulder joint to stretch and expand the capsule, providing relief from stiffness.
• Manipulation Under Anesthesia (MUA) - In some cases, MUA may be performed to break up adhesions and scar tissue, allowing for improved mobility. It involves the patient being put under anaesthesia while the doctor moves the shoulder joint.
• Surgery - If conservative treatments are ineffective, arthroscopic surgery may be considered. Dr Rajesh Malhotra will release the tight capsule and remove any scar tissue, enabling the shoulder to move more freely.

Recovery

The recovery period for frozen shoulders varies from person to person. It can take several months to years to regain full shoulder function. Adherence to the prescribed treatment plan, including regular physical therapy and home exercises, is crucial for optimal recovery. Patience and consistent effort are key to achieving the best possible outcomes. And Dr. Rajesh Malhotra helps his patients to get maximum positive outcomes from their frozen shoulder treatment.