Frozen shoulder

Frozen shoulder treatment in Hyderabad by Dr. Aditya Kapoor

The symptoms associated with this condition can worsen over time. Aging people most often develop this condition. People between 40 to 60 years of age are susceptible. The condition occurs more often in women and also in people with diabetes. The progressively worsening symptoms of a frozen shoulder tend to get better over time, but a complete recovery may take a very long time.

Your shoulder joint has three bones – the humerus (the upper arm bone); scapula (shoulder blade) and clavicle (collarbone). The Humerus head fits into the shallow socket of your shoulder blade and forms a shoulder joint. A strong connective tissue surrounds this joint. It is known as the shoulder capsule. For smooth friction-free movement – synovial fluid lubricates the joint.

What happens in a frozen shoulder?

The shoulder capsule becomes stiff, tight, and thickens. Adhesions – thick tissue bands develop. The shoulder joint also lacks adequate synovial fluid. Those who develop this condition have severe shoulder pain and an inability to move the shoulder either on their own or with others’ help. The smooth connective tissues of the shoulder joint capsule become thick, stiff, and inflamed. Frozen shoulder develops in three stages:

Freezing (stage 1)

It is associated with severe pain. The pain gradually becomes worse. The joint slowly starts to lose a range of motion. This stage can last from six weeks to eight months.

Frozen (stage 2)

In this stage – the pain subsides to some extent and may become mild to moderate, but the stiffness remains. The frozen stage can last for up to four to five months or more. Day-to-day activities can become very trivial for those who progress to this stage.

Thawing (Stage3)

The movement gradually starts to improve and slowly but steadily becomes normal. However, complete recovery and normalcy may take around 6 months to 24 months. During this time, you will gain normal strength and motion.

What are the causes of frozen shoulder?

The exact cause of a frozen shoulder is idiopathic or not clear. It is also not clear whether an occupation or an arm dominance could be the cause. However, some risk factors can increase your risk of developing a frozen shoulder.

Immobilization: The lack of motion in the shoulder joint. It can occur following an injury, shoulder fracture, or surgery. People tend to immobilize their shoulders to avoid triggering pain.

Other conditions: Some people with hyperthyroidism, hypothyroidism, cardiac disease, and Parkinson’s disease also have frozen shoulder as an associated condition.

Diabetes: People with diabetes have an increased risk of developing a frozen shoulder though the reason is unknown. Furthermore, the degree of stiffness is more in people who have diabetes and the stiffens tend to linger for a long time before thawing.

Frozen shoulder symptoms

The signs and symptoms associated with a frozen shoulder include aching or dull pain. During the early stages of the condition, the pain progressively becomes worse and intensifies when you try to move your shoulder joint. The pain is confined to the outer area of the shoulder and sometimes to the upper arm.

Examination (Diagnosis)

Dr. Aditya Kapoor will ask you about your symptoms while examining your shoulder and discussing your medical history. He will move your shoulder in a wide range of directions to see whether you have any limited or restricted motion. This range of motion is known as the passive range of motion as the doctor moves your shoulder. When you move your shoulder on your own it is known as active range of motion. Dr. Aditya Kapoor compares both types of motions.

Dr. Aditya Kapoor will order other imaging tests to rule out the possibility of other conditions such as bone fractures, tendons tear, and arthritis.

X-rays: This simple imaging test helps in detecting bone fractures and arthritis of the shoulder joint.

To get more clear pictures of your shoulder joint, the doctor may recommend an ultrasound and MRI. A highly sensitive test like MRI may also help in identifying rotator cuff tears as well.

Treatment

The primary treatment that Dr. Aditya Kapoor recommends for a frozen shoulder is physiotherapy. The objective of the treatment is to improve shoulder flexibility, strength, and mobility.

Non-surgical treatment for frozen shoulder

Pain relieving medicines – NSAIDs such as ibuprofen and aspirin can help relieve pain and inflammation.

Cortisone injections for frozen shoulder treatment: This steroid injection has powerful anti-inflammatory properties. It is given directly into the shoulder joint.

Hydrodilatation: In this procedure, a radiologist injects sterile fluid into the shoulder joint to expand and stretch the joint capsule. The radiologist uses imaging to guide the placement of fluid.

Physiotherapy: An experienced physiotherapist under his supervision lets you perform a specific set of exercises to help restore motion and get rid of stiffness in the shoulder joint.

Frozen shoulder treatment in Hyderabad – Surgery

If the above non-surgical treatments do not offer any relief, then you should discuss with your orthopedic doctor regarding shoulder surgery. Your doctor will recommend surgery in stage 2 of shoulder dislocation. The goal of surgery is to release stiffness and stretch the joint capsule. There are two common approaches:

Manipulation under anesthesia: Your orthopedic doctor forcefully maneuvers your shoulder in different directions making you sleep under anesthesia. This movement causes the joint capsule to stretch or tear. This procedure loosens the stiffness and improves motion.

Shoulder Arthroscopy: Your doctor makes small incisions and then cut the stiff portions of your joint capsule. An orthopedic doctor who specializes in arthroscopy uses thin, small, tube-like instruments to perform this procedure.

In most cases, both the above procedures are used together to achieve optimum results. Many patients report fabulous outcomes with both manipulation and shoulder arthroscopy.