frozen shoulder
 

frozen shoulder

 

adhesive capsulitis

A frozen shoulder can be defined as a loss of both active (movement without assistance) and passive (movement with assistance) motion.

 

Frozen shoulder, also called adhesive capsulitis, is stiffness, pain, and limited range of movement in a person's shoulder that usually follows on from an injury. The tissues around the joint stiffen, scar tissue also begins to form and moving the shoulder becomes painful and difficult.

CAUSES:

Frozen shoulder can develop when you stop using the joint normally because of pain, injury, or a chronic health condition, such as arthritis or diabetes. Any shoulder problem can lead to frozen shoulder if you do not work to maintain the full range of motion in the shoulder.

Frozen shoulder occurs:

  • Most often in people  aged Forty to Seventy.
  • After injury or surgery.
  • Most often in people with chronic diseases.
  • More often in women (especially in postmenopausal women) than men.
 TREATMENT:

 Painful stage:

Physiotherapy (non-aggressive) Non-Steroidal anti inflammatory drugs, intra-articular cortisone injections and analgesics – may provide some relief and benefit. Aggressive therapy often makes the condition worse. Evidence indicates use of cortisone taken orally (A university trial showed effective use of 30mg Prednisolone for Three weeks) is most effective in slowing the inflammatory process and as a consequence decreasing pain.

Adhesive Stage:

Physiotherapy including exercises has traditionally been used. No evidence showing this, on its own, is more effective than time progression itself. Lots of anecdotal evidence though.

A randomized double blind placebo-controlled trial of hydrodilatation has demonstrated at least short-term efficacy of hydrodilatation over placebo in patients with frozen shoulder. Then a six week course of physiotherapy following the hydrodilatation has shown to be effective in decreasing the pain, improve range of motion, and shortens the duration of the injury.

Some other treatments include manipulation under anesthetic and surgery – no evidence exists that these are effective in reducing the natural time progression of the condition.

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