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Frozen Shoulder: Causes And Symptoms

frozen shoulder

Ramnath is a 50-year-old man who works in an automobile manufacturing company.  Off late he has been experiencing a dull pain near his shoulder region which in some cases does spread over his right arm. He has been trying out all the natural remedies and massages to ease the dull pain but in vain. Now the pain started to interfere with his work. He is not able to move his hand above the head. He can’t even reach his back as the pain intensifies. When consulted his family doctor, he was diagnosed with a condition known as frozen shoulder. He is currently on medication and physiotherapy sessions to improve joint mobility of the shoulder region.

Medically termed as adhesive capsulitis, most of us might have heard about frozen shoulder for the first time. But according to a study published online[1], the incidence of this condition is seen in approximately 3% to 5% of the general population. Moreover, if you have diabetes, then the risk can increase to as high as 20% as compared to nondiabetics[1]. So to help you out to know more about the condition, we have explained in detail the causes and symptoms of frozen shoulder. But before that, let’s get the basics cleared.

What Is Frozen Shoulder?

Frozen shoulder is an extremely painful and debilitating condition leading to stiffness and disability of the shoulder. Our shoulder is made up of connective tissues, bones, tendons, and ligaments. When the tissues in the shoulder joint become thicker and tighter, it can cause scarring of the tissue and also impairs the mobility of the joint due to lack of proper space. As a result, adhesions and inflamed shoulder joint develop in the shoulder joint that leads to a frozen shoulder. Moreover, there is a loss of lubricating synovial fluid from the joint which increases the friction and pain.

The common symptoms include swelling, pain, and stiffness. People above the age of 50 are more likely to have shoulder pain because of weakening of the joints and tissues and the immune system[2]. It usually affects only one shoulder and may improve on its own in a span of one year to three years. Moreover, people who suffer from frozen shoulder on one side can develop it on the other side as well. The condition occurs slightly more often in women than in men.

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What Causes Frozen Shoulder?

You will not get frozen shoulder overnight. The exact cause of frozen shoulder is not yet understood but it is believed to occur when the shoulder joint becomes inflamed causing the tissues in and around the joint to shrink and harden affecting the mobility.

Moreover, there are certain factors which can up the risk of the condition. The factors can jointly contribute to the inflammation of the tissues near the shoulder joint[1]. The roots of frozen shoulder condition can be traced to conditions such as

-Diabetes

-Cardiovascular diseases

-Stroke

-Parkinson’s disease

-Thyroid disease

-Hormonal imbalance

-Weakened immune system

Another major reason causing shoulder pain and frozen shoulder is a prolonged period of inactivity due to illness, injury or surgery that limits your shoulder movement to a great extent.

Symptoms of Frozen Shoulder

Do you find it painful to move your shoulders?

Do you feel that shoulder pain is limiting your movement?

If yes, then you are most likely to have a frozen shoulder.

You realize you have a frozen shoulder only when the shoulder starts hurting. Your range of arm movement is restricted, and the pain increases gradually over time making your shoulder stiffer day by day. It becomes very difficult to do everyday tasks that involve stretching your shoulder such as grabbing objects from a shelf located high in the kitchen or apply soap on your back while taking a bath. You realize that your condition has worsened when you cannot lift your arm for wearing clothes.

Here are the stages of the frozen shoulder[3]:

Stage 1: Freezing

The beginning of the shoulder pain is the freezing stage during which your range of movement gets restricted. It typically lasts for 6 weeks to 9 months. It causes a gradual increase in the intensity of the pain with movement but the pain remains fairly constant.

Stage 2: Frozen

In this stage, there is a reduction in the severity of the pain. However, stiffness of the shoulder increases, which in turn, limits your ability to perform even the daily tasks involving shoulder movement. It may last for around 4 months to 12 months.

Stage 3: Thawing stage

This is the stage in which the shoulder motion improves slowly, and it comes back to normal condition at the end of the thawing stage. It lasts from 6 months to 2 years.

Identifying the above signs and symptoms during the early stages will ensure that you get timely and appropriate shoulder pain treatment. The diagnosis of frozen shoulder is based on the symptoms experienced followed by a physical examination of the shoulder by an expert. Although the condition improves with time, your doctor might prescribe painkillers and steroids to reduce pain and inflammation respectively. The use of ice packs or cold packs to ease the pain is also advised. In some cases, stretching exercises and physiotherapy is recommended to improve joint mobility.

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If you have witnessed any similar symptoms or have any doubts about frozen shoulder, let us know in the comment section below.

(The article is reviewed by Dr. Lalit Kanodia, General Physician)

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References:

1. Le HV, Lee SJ, Nazarian A, Rodriguez EK. Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder Elbow. 2017 Apr;9(2):75-84.

2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Frozen shoulder: Overview. 2008 Sep 18 [Updated 2018 Jul 12].

3. Rangan A, Goodchild L, Gibson J, Brownson P, Thomas M, Rees J, Kulkarni R. Frozen Shoulder. Shoulder Elbow. 2015 Oct;7(4):299-307.

4. Frozen Shoulder – Adhesive Capsulitis – OrthoInfo – AAOS [Internet]. orthoinfo.aaos.org. 2018 [cited 27 September 2018].

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