|
Frozen shoulder
Definition
Frozen shoulder is the common term for adhesive capsulitis, an inflammatory condition that restricts motion in the shoulder.
Alternative Names
Adhesive capsulitis
Causes
The capsule of a shoulder joint includes the ligaments that attach the shoulder bones to each other. When inflammation occurs within the capsule, the shoulder bones are unable to freely move within the joint.
Diabetes, shoulder trauma (including surgery), a history of open heart surgery, hyperthyroidism, and a history of cervical disk disease are all associated with an increased risk for this problem. Often, there is no known cause.
Symptoms
The main symptoms are pain and stiffness.
In those with idiopathic frozen shoulder (frozen shoulder without an identifiable cause), pain is usually the first symptom. The patient usually does not want to move the arm. The lack of movement leads to stiffness, which is the second phase of the disease. The third phase, thawing, is when the motion and function of the shoulder slowly returns.
Exams and Tests
The diagnosis is made primarily by physical exam and the patient's medical history. There is usually a history of shoulder pain followed by severe stiffness, which may not be very painful. If the patient has any history of the risk factors associated with frozen shoulder, these may require treatment as well.
Imaging studies such as x-rays are routine to make sure there is no other problem, such as arthritis. MRI exams may show widespread inflammation, but there are no findings specific to frozen shoulder.
Treatment
Treatment involves non-steroidal anti-inflammatory medications (NSAIDs), steroid injections, and physical therapy. It can take as long as 12-18 months to see improvement. The physical therapy is intense and needs to be done every day. Steroid injections can significantly improve the results of physical therapy.
If therapy is not successful, or if a patient can not tolerate therapy, a shoulder manipulation may be performed. This procedure is done under anesthesia. The health care provider will forcibly bring the shoulder through a range of motion to release the scar tissue.
Arthroscopic surgery can be used to cut the tight ligaments and remove the scar tissue from the shoulder. Some surgeons may use repeated pain blocks after surgery so the patient can participate in physical therapy after surgery.
Outlook (Prognosis)
With therapy and NSAIDs, the problem will usually resolve within a year. When required, surgery is usually successful in restoring motion, but therapy must be continued for several weeks to months after surgery to prevent recurrence. The most common reason for any treatment to fail is non-compliance with therapy.
Possible Complications
Complications include persistent stiffness and pain despite therapy. If there is forceful manipulation of the shoulder during surgery, the arm can break.
When to Contact a Medical Professional
If you have shoulder pain and stiffness and suspect you may have a frozen shoulder, contact your health care provider for proper referral and treatment.
Prevention
The best way to prevent frozen shoulder is to contact your health care provider if you develop shoulder pain that limits your range of motion for an extended period of time. This will allow early treatment and help avoid stiffness, if possible.
Patients with diabetes should keep tight control of their blood glucose levels.
Sheridan MA, Hannafin JA. Upper extremity: emphasis on frozen shoulder. Orthop Clin North Am. 2006 Oct;37(4):531-9. Review.
Brue S, Valentin A, Forssblad M, Werner S, Mikkelsen C, Cerulli G. Idiopathic adhesive capsulitis of the shoulder: a review. Knee Surg Sports Traumatol Arthrosc. 2007 Feb 28; [Epub ahead of print].
Email to a Friend
Typical mistypes for Frozen shoulder
drozen shoulder, crozen shoulder, vrozen shoulder, grozen shoulder, trozen shoulder, rrozen shoulder, feozen shoulder, fdozen shoulder, ffozen shoulder, ftozen shoulder, f5ozen shoulder, f4ozen shoulder, frizen shoulder, frkzen shoulder, frlzen shoulder, frpzen shoulder, fr0zen shoulder, fr9zen shoulder, froxen shoulder, frosen shoulder, froaen shoulder, frozwn shoulder, frozsn shoulder, frozdn shoulder, frozrn shoulder, froz4n shoulder, froz3n shoulder, frozeb shoulder, frozem shoulder, frozej shoulder, frozeh shoulder, frozen ahoulder, frozen zhoulder, frozen xhoulder, frozen dhoulder, frozen ehoulder, frozen whoulder, frozen sgoulder, frozen sboulder, frozen snoulder, frozen sjoulder, frozen suoulder, frozen syoulder, frozen shiulder, frozen shkulder, frozen shlulder, frozen shpulder, frozen sh0ulder, frozen sh9ulder, frozen shoylder, frozen shohlder, frozen shojlder, frozen shoilder, frozen sho8lder, frozen sho7lder, frozen shoukder, frozen shoupder, frozen shouoder, frozen shoulser, frozen shoulxer, frozen shoulcer, frozen shoulfer, frozen shoulrer, frozen shouleer, frozen shouldwr, frozen shouldsr, frozen shoulddr, frozen shouldrr, frozen should4r, frozen should3r, frozen shouldee, frozen shoulded, frozen shouldef, frozen shouldet, frozen shoulde5, frozen shoulde4, rozen shoulder, fozen shoulder, frzen shoulder, froen shoulder, frozn shoulder, froze shoulder, frozenshoulder, frozen houlder, frozen soulder, frozen shulder, frozen sholder, frozen shouder, frozen shouler, frozen shouldr, frozen shoulde, rfozen shoulder, forzen shoulder, frzoen shoulder, froezn shoulder, frozne shoulder, froze nshoulder, frozens houlder, frozen hsoulder, frozen sohulder, frozen shuolder, frozen sholuder, frozen shoudler, frozen shouledr, frozen shouldre, ffrozen shoulder, frrozen shoulder, froozen shoulder, frozzen shoulder, frozeen shoulder, frozenn shoulder, frozen shoulder, frozen sshoulder, frozen shhoulder, frozen shooulder, frozen shouulder, frozen shoullder, frozen shouldder, frozen shouldeer, frozen shoulderr, etc.
|
|
|
