Frozen Shoulder

Frozen shoulder is a common disorder that causes pain, stiffness, and loss of normal range of motion in the shoulder. The resulting disability can be serious, and the condition tends to get worse with time if it's not treated. It affects mainly people ages 40 to 60 with women affected more often than men.

Causes of  Frozen Shoulder:

The causes of this condition is classified into primary and secondary

i. Primary idiopathic that is no clear cause

ii. Secondary involves;

• Immobilization
• Diabetic mellitus
• Hypo and hyperthyroidism
• Autoimmune conditions
• Trauma (including surgeries)
• History of cervical disc diseases -advanced age 

Symptoms of Frozen Shoulder:

• pain in your shoulder which can be worse at night and disturb sleep.
• stiffness in your shoulder which makes it difficult to move.

Stages Of Frozen Shoulder:

• Freezing (Pain)
• Frozen (Stiffness)
• Thawing (Reduction)

Pathology of Frozen Shoulder:

• Every joint is covered by a capsule that is made up with a lining known as a synovium.
• Inflammation of the synovium (synovitis) is the initial cause of pain.
• Fibrosis, in the process of tissue repair brings about the reduced range of motion.

Diagnosis of Frozen Shoulder:

This condition is a clinical diagnosis that is diagnosed through

• Clinical presentation.

• Physical examination. 

Investigations Frozen Shoulder:

• Do not have a significant role
• PLAIN XRAY is normal.

However, it can be used to rule out other conditions. Commonly revealed conditions are osteoporosis, degenerative changes, decreased space between acromion and humeral head, calcium deposits and cystic changes.

Treatment of Frozen Shoulder:

• Manipulation under anaesthesia (70% cases respond well)
• Steroids injection
• Anti-inflammatory e.g.NSAIDS
• Diabetic control e.g., use of insulin.
• Heating
• Acupuncture

• Physical therapy

Physiotherapy Treatment of Frozen Shoulder:

• Thermotherapy: Before resorting to passive mobilization, the thick and contracted capsule must be released and made more stretchable by deep heating using ultrasonic or other suitable modalities The heating is carried out throughout the joint.

• Passive physiological exercise: motion in a range that usually is achieved actively
  

• Accessory exercise: motion between joint surfaces, which cannot be achieved actively.

• Shoulder strengthening  exercises:

• Shoulder stretching exercises:

Role of the Patient:

• Patient heal thyself”
• Home treatment regimen

Pendulum exercises: in a forward stooping position, with one hand resting on a table or chair, the patient gradually swings the arm like a pendulum and later carries out a circumduction movement. 5 times daily in 5-to-10-minute sessions.

External rotation passive stretch for frozen shoulder:

• Stand in a doorway and bend your affected arm 90 degrees to reach the doorjamb.
• Keep your hand in place and rotate your body as shown in the illustration.
• Hold for 30 seconds. Relax and repeat.

Forward flexion supine position:

• Lie on your back with your legs straight. Use your unaffected arm to lift your affected arm overhead until you feel a gentle stretch.
• Hold for 15 seconds and slowly lower to start position. Relax and repeat.

Crossover arm stretch:

• Gently pull one arm across your chest just below your chin as far as possible without causing pain.
• Hold for 30 seconds. Relax and repeat.

Shoulder Exercise Wall-Climbing to the Front:

• Face a wall, standing so your fingers can just touch it.
• Keeping your shoulder down (don't shrug up toward your ear), walk the fingers of your injured arm up the wall as high as pain permits.
• Hold that position for at least 15 to 30 seconds.
• Slowly walk your fingers back down to the starting position.
• Repeat at least 2 to 4 times, trying to reach higher each time.

Shoulder Wheel Exercises: to be done by the patient himself at the physiotherapy center

Pulley Exercises: which can be done by the patient himself at home.

Frozen shoulder rehabilitation exercises:

Why Do You Come to Spine Physiotherapy and Rehabilitation Centre (SPTRC) for Frozen Shoulder ?

Our physiotherapy staff in Shyamoli is very skilled in treating Frozen Shoulder. Before treating you, we must first assess the patient, discuss with them, and create a treatment plan. We offer shockwave therapy, acupuncture therapy, electromagnetic field therapy, intermittent cryotherapy, and more. We can immediately relieve your pain.  

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