All you need to know about Frozen Shoulder.
Know your ailment well, so you can manage it better!!
Here we come with Adhesive Capsulitis today!
What is Adhesive Capsulitis?
Adhesive Capsulitis is also known as Frozen Shoulder and Frozen Shoulder Syndrome (FSS).
A painful condition in which the mobility of the shoulder becomes restricted is frozen shoulder, also called adhesive capsulitis.
As the solid connective tissue around the shoulder joint (called the capsule of the shoulder joint) becomes thick, tight, and inflamed, frozen shoulder occurs. (The joint capsule includes the ligaments that connect the top of the upper arm bone [humeral head] to the [glenoid] shoulder socket, securing the joint tightly in place. It is more generally referred to as the joint of the “ball and socket”.)
The disease is known as the “frozen” shoulder and the more pressure is felt, the less possible it is to use the shoulder. Lack of use allows the capsule of the shoulder to thicken and become rigid, making it much harder to raise the shoulder — it is “frozen” in its place.
What are the causes of Adhesive Capsulitis?
There is no complete explanation of the causes of the frozen shoulder. The relation to arm supremacy or occupation is not obvious. A few factors may put you at greater risk of frozen shoulder growth.
Getting diabetes. In persons with diabetes, frozen shoulder happens even more frequently. It is not clear the explanation for this. Furthermore, diabetic frozen shoulder patients appear to have a higher degree of stiffness that lasts until “thawing.” for a longer period.
Such pathologies. Hypothyroidism, hyperthyroidism, Parkinson’s disease, and heart disease are other additional medical conditions associated with frozen shoulder.
Immobilization. Immobilization After a shoulder has been immobilised for a period of time due to surgery, fracturing, or other damage, the frozen shoulder may form. One measure is recommended to stop frozen shoulder if patients have moved their shoulders shortly after an accident or surgery.
What are the symptoms of Adhesive Capsulitis?
These symptoms are expressed as stages:
- Upper extremity trauma (eg, shoulder surgery, rotator cuff tear, proximal humerus fracture)
- Immobilization (eg, cardiothoracic surgery, neurosurgery)
- Metabolic/endocrine (eg, thyroid disease, diabetes mellitus, autoimmune disease, hyperlipidemia)
- Neurologic (eg, stroke, Parkinson disease)
- Cardiac disease (eg, ischemic heart disease, hypertension)
- Drugs (eg, protease inhibitors, antiretrovirals, immunizations, fluoroquinolones)
- Malignancy
What are the stages in Adhesive Capsulitis?
The shoulder capsule thickens and becomes rigid and strong in the frozen shoulder. Thick tissue bands, called adhesions, grow. In certain cases, the joint has less synovial blood.
Extreme pain and being unable to lift your shoulder are the signature symptoms of this disease — either on your own or with someone else’s help. In three steps, it evolves
Stage 1: Freezing
In the “freezing” stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
Stage 2: Frozen
Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.
Stage 3: Thawing
Shoulder motion slowly improves during the “thawing” stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.
What are the risk factors of Adhesive Capsulitis?
- Age: Men, most usually between the ages of 40 and 60.
- Gender: More prevalent in women than in men.
- Current shoulder injury: Any injury to the shoulder or surgery that results in the need to stop moving the shoulder (i.e., by using a shoulder brace, sling, shoulder wrap, etc.). A rotator cuff tear and fractures of the shoulder blade, collarbone or upper arm are examples.
- Diabetes: 10 to 20% of people with diabetes mellitus experience a frozen shoulder.
- Such health disorders and illnesses include stroke, hypothyroidism (underactive thyroid gland), Parkinson’s disease, hyperthyroidism (overactive thyroid gland), and cardiac disease. For frozen shoulder, stroke is a risk factor since mobility of the arm and shoulder can be restricted. Why the risk of having a frozen shoulder is raised by other diseases and conditions is not evident.
What are the risk factors of Adhesive Capsulitis?
Residual shoulder stiffness or inflammation is the primary condition resulting from adhesive capsulitis. Several studies have suggested that, for up to 3 years after conservative treatment, most patients may appear to have discomfort and/or stiffness. Furthermore, after shoulder manipulation, humeral fracture, biceps tendon rupture, and subscapularis tendon rupture have been recorded.
How is Adhesive Capsulitis diagnosed?
In order to diagnose a frozen shoulder, the doctor will do the following:
- Discuss the signs and get a medical history review.
- Conduct a physical test of your shoulders and arms:
- To assess the range of motion and if there is pain of movement, the doctor will turn the shoulder in both directions. Determining your “passive range of motion” is considered this form of test, in which your doctor is moving your arm and not you.
- The doctor is even going to watch you turn your arm to see your “active motion range.”
- They compare the two forms of motion. There is a small spectrum of aggressive and passive motion for those with a frozen shoulder.
- To guarantee that the cause of the symptoms is not due to any shoulder injury, such as arthritis, X-rays of the shoulder are often regularly taken. For frozen shoulder diagnosis, advanced imaging testing, such as magnetic resonance imaging (MRI) and ultrasound, are typically not needed. They may be taken to check at other stuff, such as a tear in a rotator cuff.
What is the treatment for Adhesive Capsulitis?
Treatment normally requires methods of pain management before the initial period disappears. If the condition remains, if it doesn’t recover on its own, medication and surgery might be required to restore motion. Such straightforward therapies include:
- Compresses which are hot and cold. This help alleviates swelling and discomfort.
- Medicines that reduce swelling and discomfort. That are anti-inflammatory nonsteroidal medications (NSAIDs), such as ibuprofen (Advil®, Motrin®) and acetaminophen (Tylenol®). Your doctor can recommend other painkiller/anti-inflammatory drugs. Steroid injections can control more intense pain and swelling. Directly into the shoulder bone, a corticosteroid such as cortisone is inserted.
- Physical counselling. Exercises taught by a physical trainer for stretching and range of motion.
- Software for home fitness. Continuing the home fitness routine.
- Transcutaneous activation of electrical nerves (TENS). Use of a small battery-operated device that reduces pain by blocking nerve impulses.
- If these simple treatments have not relieved pain and shoulder stiffness after about a year trial, other procedures may be tried. These include:
- Manipulation under anesthesia: During this surgery, you will be put to sleep and your doctor will force movement of your shoulder. This will cause the joint capsule to stretch or tear to loosen the tightness. This will lead to an increase in the range of motion.
- Shoulder arthroscopy: Your doctor will cut through the tight parts of your joint capsule (capsular release). Small pencil-sized instruments are inserted through small cuts around your shoulder.
- These two procedures are often used together to get better results.
How to Prevent Adhesive Capsulitis?
The immobility that can result during healing from a shoulder injury, fractured arm or a stroke is one of the most common causes of frozen shoulder. Speak to the doctor about exercises you should perform to preserve the range of motion of your shoulder joint if you have sustained an injury that makes it impossible to lift your shoulder.
References:
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https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684
https://orthoinfo.aaos.org/en/diseases--conditions/frozen-shoulder/
https://my.clevelandclinic.org/health/diseases/15359-frozen-shoulder
