Frozen shoulder is a condition that affects the shoulder joint, also known as adhesive capsulitis, characterized by initial pain followed by progressive restricted active and passive joint (glenohumeral) range of motion. It progresses through three phases: the freezing phase, where sharp pain is present at rest and during extremes of movement, often accompanied by night pain and disrupted sleep, which can last anywhere from 3-9 months; the frozen phase, marked by more stiffness and pain at extremes of movement, with a progressive loss of glenohumeral movement in the capsular pattern, lasting about 4 months to 12 months; and the thawing phase, which sees progressive improvement in functional range of motion and can last from 1 to 3.5 years.
Symptoms of Frozen Shoulder:
Frozen shoulder involves restricted movement of the shoulder joint with symptoms including:
- Progressive increase in shoulder pain.
- Decreased active and passive range of motion in the shoulder.
- Stiffness in the arm.
- Disrupted sleep due to shoulder pain.
- Difficulty performing overhead activities, such as combing, grooming, dressing, or fastening items behind the back.
Causes of Frozen Shoulder:
Frozen shoulder can arise spontaneously, but various factors increase the risk, including:
- Post-surgical interventions or shoulder injury.
- Diabetes mellitus, Parkinson’s disease, stroke, thyroid disorders.
- Cancer or Dupuytren’s disease.
- Complex regional pain syndrome.
Diagnosis:
Diagnosis includes:
- Physical Examination: Assessment of cervical, thoracic, and shoulder range of motion.
- X-rays: To identify any bone issues like bone spurs.
- MRI: To identify soft tissue damage (though MRI can’t diagnose frozen shoulder directly).
- Lab Tests: To detect underlying conditions like diabetes or polymyalgia rheumatica that increase the risk of frozen shoulder.
Treatment for Frozen Shoulder:
Treatment can involve:
- Medicines: Non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, painkillers, or corticosteroid injections (only with doctor’s prescription).
- Joint Distension: Sterile water is injected into the shoulder capsule to stretch it.
- Surgery: Arthroscopy may be considered if other treatments fail.
Physiotherapy Treatment for Frozen Shoulder:
Physiotherapy plays a crucial role in managing frozen shoulder, and treatment options include:
- Thermotherapy (Heat therapy) for pain relief and joint mobilization.
- Cryotherapy (Cold therapy) to reduce pain and inflammation.
- Ultrasound Therapy: Deep heat to aid tissue healing.
- TENS (Transcutaneous Electrical Nerve Stimulation): For pain reduction and swelling control.
- Laser Therapy: To reduce inflammation and restore joint function.
- Kinesiology Taping: For support, reducing edema, and improving joint mobility.
- Gentle Shoulder Mobilization: Passive movements of the shoulder to relieve stiffness.
- Stretching Exercises: Including sustained and dynamic stretching patterns to increase the shoulder’s range of motion.
- Strengthening Exercises: To improve shoulder strength and prevent further injury.
Patient Education and Self-Care:
Patients are advised to:
- Perform regular stretching exercises to avoid stiffness recurrence.
- Diabetic patients may experience slower recovery and more intense pain, requiring more comprehensive treatment.
At PhysioFusion Physiotherapy Clinic, we provide comprehensive physiotherapy treatment for frozen shoulder. Our team uses a combination of manual therapy, rehabilitation programs, stretching exercises, and pain management techniques tailored to each individual’s condition. We are dedicated to helping you regain shoulder mobility, reduce pain, and restore function through evidence-based treatments designed to optimize your recovery process.