Frozen Shoulder – Learn Where your Pain Comes from

Pain in the neck and shoulders is well known to all who have to stare into a computer screen all day. And yet, if you suddenly lose the ability to move your shoulder, it can be scary. Fear not: most probably, you have frozen shoulder.

Image Credit: helios-gesundheit.de

There is a wide range of shoulder and neck issues that can cause soreness and pain, but frozen shoulder – or adhesive capsulitis – is quite easy to recognize. First, a person developes a nagging, sometimes strong pain in the shoulder, and moving the arm becomes painful. Then the shoulder becomes stiff, sometimes to the point where you cannot drive or exercise. After 12-18 months, the condition usually resolves on its own. Frozen shoulder can be treated, though – but it is useful to understand where it comes from.

Why and how shoulders “freeze”

In our shoulder joint, three bones come together – humerus (upper arm), collarbone, and scapula (shoulderblade). The joing is surrounded by a capsule made of connective tissue (more on anatomy here). Sometimes the connective tissue thickens and stiffens, and the amount of fluid is reduced. The result is pain and the loss of range of motion. The scientific name for the disorder is adhesive capsulatis.

Three stages of adhesive capsulitis

  1. Freezing – this stage lasts for 6-9 months and is expressed in almost constant pain or soreness, especially when you try to move the arm, and a progressive loss of motion.
  2. Frozen – in this stage, which lasts circa 6-8 months, the pain is reduced, but the shoulder becomes very stiff – many activities can become impossible.
  3. Thawing – in the last stage, the pain reduces and the motion gradually returns. Finally, a year and a half or two years after it began, the disorder resolves.

Unclear causes

Doctors argue about the causes of adhesive capsulitis. An injury can cause it, especially when it leaves the arm immobile for long (in a plaster cast, for example). Some sports can cause frozen shoulder, in particular freestyle swimming and everything that requires throwing a ball from behind your head. Some physical disorders increase the risk – diabetes and obesity are good examples. Still, many people get adhesive capsulitis for no clear reason at all (more on causes here).

Treatment options

  1. Exercise – you absolutely have to move your shoulder, otherwise it will become even stiffer. If you can, do these simple exercises:
  • Stand facing a wall and place your hand on the wall in front of your face; now move the hand up and down along the wall;
  • Stand with your feet wide and bend down from the waist, allowing your arms to hang down. Now make circles above the floor with your arms.
  • Extend your arm parallel to the floor in front of you and use the other hand to pull your straight arm towards the opposite shoulder. Remember: some discomfort is ok but not strong pain.

2. Physio therapy – if you cannot move your arm, a physio therapist can do it for you, sometimes under anaesthesia (more info here).
3. Injections – corticosteroids are often injected to reduce inflammation and pain. Painkillers are also often prescribed.
4. Arthroscopy – in this innovative method (which few surgeons use, however), fluid – usually distilled water – is injected into the shoulder capsule.
5. Acupuncture – needle pressure on trigger points in the shoulder muscle often relieves pain.

Frozen shoulder can be annoying, but it will eventually go away. However, you don’t have to suffer for two years – efficient treatments do exist. The important thing is to go to the doctor as soon as you develop symptoms~!

References:

7 stretching & strengthening exercises for a frozen shoulder  – Health.harvard.edu
Diagnosis and management of adhesive capsulitis – Ncbi.nlm.nih.gov
Frozen shoulder – Orthoinfo.aaos.org

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