Frozen Shoulder Syndrome – Symptoms, Treatment, Causes

What is Frozen Shoulder Syndrome?

Frozen Shoulder syndrome is also called as adhesive capsulitis or FSS, and it is a disease condition that manifests pain and stiffness of the affected person’s shoulder joint. The stiffening is a normal body response or reaction to inflammation process in or near the person’s shoulder area. The term “adhesive” means in layman’s term as sticky and “capsulitis” which means inflammation of the affected person’s joint capsule. It is a disease condition that affects the ability of the affected person’s shoulder to move normally and freely. People experiencing this kind of syndrome have been reported to have difficulty reaching to their lower back and overhead areas. The shoulder capsule located inside the shoulder joint is also affected.

Frozen Shoulder Syndrome

Frozen Shoulder Syndrome Symptoms and Signs

When a person has this experience Frozen Shoulder syndrome, he or she will manifest the following signs and symptoms:

• Pain at the shoulder which may be aching, dull pain
• Stiffness
• Limited movement of the affected shoulders

The signs and symptoms mentioned above have actually three phases namely:

Phase one: Painful Stage

It is also called as the freezing stage by some. This stage is known to last for about 2 months to 9 months. The first symptom associated with this syndrome is pain which is worse whenever you lie at the affected area or side and much worse at night time. Also, the limited range of motion begins to be felt or experience during this first stage.

Phase two: Frozen Stage

It is also called as the adhesive phase which is known to last for about 4 to 12 months. The pain become manageable in this stage but still there is limited movement and stiffness present and could even get worse. In this stage, the muscles that surround the affected shoulder became wasted or flaccid as it is not used due to the fact that there is limitation of movement. In addition to that, pain may disappear but the stiffness and the limited movement is notably felt.

Phase three: Thawing Stage

It is the last and final stage which is sometimes called as recovery phase. It last at around 5 to 4 years. Here the pain and stiffness will gradually disappear and the patient is able to return to its normal shoulder movement without anymore limitations imposed. There is a gradual improvement of the patient’s shoulders range of motion.

Frozen Shoulder Syndrome Causes & Risk Factors

Basically the etiology of persons having frozen shoulder or adhesive capsulitis, are still up to now, poorly comprehend by many. However there are theories that pinpoint the possibility of why such a syndrome occurs such as:

1. Postural– Some studies says that long standing rounded shouldered posture will eventually lead to shortening of the shoulder ligaments of the patient.
2. Genetic– Research shows that there is a genetic component that is evident on persons having frozen shoulder syndrome.
3. Autoimmune– Theory states that there is a rejection reaction to the person’s damaged tendons in his or her shoulders.
4. Hormonal– Upon research done, it is found out that such syndrome occurs on most women during their menopausal stage.
5. Idiopathic– It is basically a medical term which means unknown cause which is usually the case with most patient diagnose with this kind of syndrome.
6. Systemic Illness– People having such as illness like hyperthyroidism, lung disease, cardiovascular disease, diabetes, depression and Parkinson’s disease have encountered having frozen shoulder syndrome.
7. Post operative-It may also be due to post operative procedures which may lead to the symptoms associated with this kind of syndrome.
8. Post traumatic– When a person had just recently had arm or shoulder injury, he or she may experience having frozen shoulder syndrome.

Frozen Shoulder Syndrome Diagnosis

The doctor usually diagnoses this syndrome through doing the following:

• Medical History
• Thorough Physical Assessment
• Blood Testing
• X-ray
• Arthrography
• MRI scan

Frozen Shoulder Syndrome Treatment

When you are diagnosed to have frozen shoulder syndrome, good news is that it can be treated through the following:

Medications

Medication prescribed for this syndrome is oral or injectable steroid, NSAIDs, narcotic pain medications, sleeping pills and muscle relaxant. Some medications need to be use cautiously at it can lead to addiction or drug dependency.

Hydrodilatation

It is a method that uses 10 to 50mls of saline to inflate the affected capsule.

Hydroplasty

It deals with the injection of lidocaine, buprivacaine and corticosteroids which is followed by the injection of chilled sterile saline 30ml. It is found to be effective when it is combined with physical therapy.

Physical Therapy

It is usually done effectively in the frozen phase of this syndrome. It basically aims at reduction of inflammation and pain through modalities such as cold therapy and ultrasound, strengthening the muscles of shoulder girdle and rotator cuff in the prevention of disuse syndrome or atrophy, stretching gently the affected shoulder to prevent stiffness and make mobilization improved and lastly it tells the patients on how to do the home exercise program techniques in a proper way.

TENS

It is widely known as transcutaneous electrical nerve stimulation. It is used to relieve pain that occurs at night.

Activity Modification

Even the patient experiences pain on the affected area, the patients still are encourage to remain active and use the affected area or extremity.

Home Exercise Program

It is advised to do stretching exercise done in a gentle manner which can be done every 2-3 times every day, as much as possible.

Acupuncture

It is a famous and ancient medicine art which uses needles which is inserted in the affected body area, for this case the shoulder and its surrounding areas. It is known as a great pain reliever.

Nerve Blocks

Nerve blocks may be done through injecting the nerve to be able to reduce the discomfort felt in the shoulder. Usually a licensed anesthesiologist does this method.

Surgery

It is usually the last step of treatment option. It is necessary to do surgical procedure when the non-surgical methods have been tried and failed. Some of the surgeries that may be done are manipulation surgical procedure or arthroscopic capsular release type of surgery.

Frozen Shoulder Syndrome Prognosis

The prognosis of a person having the frozen shoulder syndrome will usually depend on the persons response to any of the treatment method mentioned above. One should have to keep in mind is that the tissues in the shoulders should not be further more injured especially when one is in the rehabilitation period. In addition to that, frozen shoulder syndrome is only considered permanent when there is no aggressive treatment applied.

Frozen Shoulder Syndrome Complications

Some possible complication associated with this syndrome includes:

• Nerve damage upon surgical procedure
• Fracture of the humerus
• Recurrent stiffness
• Instable shoulder joint
• Infection
• Damaged blood vessels

Frozen Shoulder Syndrome Prevention

In preventing to experience the frozen shoulder syndrome, you can follow these easy steps:

• Doing daily stretching exercise of your tendons, back muscles and shoulders
• Practicing good body mechanics or ergonomics especially when sitting
• Having healthy immune system
• Doing gentle exercises, such as ROM or range of motion, as earlier as possible especially after surgery and injury

Frozen Shoulder Syndrome Pictures

Frozen Shoulder Syndrome Pathophysiology

Frozen Shoulder Syndrome Management