Frozen
Shoulder (Adhesive Capsulitis)
What
Is a Frozen Shoulder?
As the name implies,
movement of the shoulder is severely restricted in people with
a frozen shoulder. This condition, which doctors call adhesive
capsulitis, is frequently caused by injury that leads to lack
of use due to pain. Intermittent periods of use may cause inflammation.
Adhesions (abnormal bands of tissue) grow between the joint
surfaces, restricting motion. There is also a lack of synovial
fluid, which normally lubricates the gap between the arm bone
and socket to help the shoulder joint move. It is this restricted
space between the capsule and ball of the humerus that distinguishes
adhesive capsulitis from a less complicated painful, stiff shoulder.
There are a number of risk factors for frozen shoulder, including
diabetes, stroke, accidents, lung disease, and heart disease.
The condition rarely appears in people under 40 years old.
What
Are the Signs of a Frozen Shoulder and How Is It Diagnosed?
With a frozen shoulder,
the joint becomes so tight and stiff that it is nearly impossible
to carry out simple movements, such as raising the arm. People
complain that the stiffness and discomfort worsens at night.
A doctor may suspect the patient has a frozen shoulder if a
physical examination reveals limited shoulder movement. An arthrogram
may confirm the diagnosis.
How
Is a Frozen Shoulder Treated?
Treatment of this
disorder focuses on restoring joint movement and reducing shoulder
pain. Usually, treatment begins with nonsteroidal anti-inflammatory
drugs and the application of heat, followed by gentle stretching
exercises. These stretching exercises, which may be performed
in the home with the help of a therapist, are the treatment
of choice. In some cases, transcutaneous electrical nerve stimulation
(TENS) with a small battery-operated unit may be used to reduce
pain by blocking nerve impulses. If these measures are unsuccessful,
the doctor may recommend manipulation of the shoulder under
general anesthesia. Surgery to probe into the joint and cut
the adhesions is only necessary in some cases.
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