Frozen shoulder

What is frozen shoulder?
A strong connective tissue, called the capsule, surrounds the shoulder joint. Frozen shoulder is a condition that occurs as a result of inflammation around your shoulder joint and its surrounding capsule. You’re more likely to get frozen shoulder if you’re aged between 40 and 60. It’s also more common among women than men. 



How it develops?
Frozen shoulder develops in 3 phases.

Freezing. During this stage you will slowly develop pain that gets worse as you lose motion in your shoulder. This stage may last from 6-30 months.
Frozen. The pain may have settled during this stage but your shoulder will remain stiff. This can last between 4-6 months.
Thawing. This is the recovery stage you will begin to get movement back in your shoulder. This stage varies between six months and two years.

Which are the Symptoms?
The symptoms are:

a deep pain in your shoulder
stiffness around your shoulder joint
restricted range of movement in your shoulder

The stiffness may make it difficult for you to do everyday tasks, such as driving, dressing or sleeping. You may also have difficulty scratching your back or putting your hand in your back pocket. The pain usually comes on gradually, and is often worse when you move your shoulder joint. It may also be worse at night. 

What causes the frozen shoulder?
The exact reason why frozen shoulder develops is not known at present. It’s thought to be caused by inflammation of your shoulder joint and its surrounding capsule. Frozen shoulder can sometimes develop if you have had a shoulder injury, such as a fracture, or if you have had surgery on your shoulder. 

Predisposing factors for frozen shoulder?
There are medical conditions that increase risk of developing frozen shoulder:
Parkinson's disease, diabetes, hypothyroidism and hyperthyroidism, cardiovascular disease

Diagnosis is extracted from medical history, physical examination, X-ray, MRI scan, Ultrasound. These tests can rule out other causes of your shoulder stiffness and pain, such as rotator cuff injury or osteoarthritis.

Treatment of frozen shoulder
Frozen shoulder will usually get better on its own. However, it can sometimes take years to completely go away. Treatment for frozen shoulder depends on the stage of your condition. If you need pain relief during the first stage of frozen shoulder, you can take  non steroidal anti-inflammatory drugs (NSAIDs).
During the early, freezing stage, it’s important to continue moving your shoulder regularly during day-to-day activities and not to stop moving your shoulder completely. 

Your doctor may refer you to a physiotherapist who will show you suitable exercises to help stretch your shoulder muscles and improve the strength and movement of your shoulder. Sometimes a steroid joint injection is a choice.

Surgery is a last choice if the other types of treatment have nοt been helpful. The following are the most common surgical methods.

Shoulder manipulation.
Your surgeon will move your shoulder around, while you are under general anaesthesia.

Shoulder arthroscopy
This is usually done under local anaesthesia. This completely blocks pain from your shoulder area and you will stay awake during the procedure. However, sometimes you will be under general anaesthesia because it can be uncomfortable for some people to stay in one position for the length of time needed to complete the procedure.
Sometimes both of these procedures are done at the same time. Most people who have surgery will have good results. If you have surgery, you will need to have physiotherapy to maintain the motion in your shoulder. It can take between six weeks and three months for you to recover.