Frozen Shoulder
The Three Phases of Frozen Shoulder
Frozen shoulder or adhesive capsulitis is a condition where the lining or capsule of the shoulder becomes very inflamed causing pain and stiffness. It becomes increasingly difficult to do daily activities as the shoulder becomes very stiff. Frozen shoulder tends to affect people 40-60 years old, and is more common in women, diabetics, and people experiencing thyroid dysfunction.
The Three Phases of Frozen Shoulder
The Freezing Stage: This first stage is marked by increasing pain and progressive stiffness in the shoulder. Initially, before the shoulder becomes stiff, symptoms can be similar to rotator cuff tendonitis or impingement. Quick motions and stretching are very painful. This phase, which is the most painful stage, can last anywhere from 1-9 months.
The Frozen Stage: In this phase, while the pain starts to improve, the shoulder remains quite stiff. This stage can last another 4-6 months.
The Thawing Stage: The shoulder range of motion begins to return. It can take another 3-6 months or more to recover full range of motion and strength.
Nonsurgical Conservative Treatments
In the Freezing stage
Rest: Avoid motions that cause sharp pain. Don’t try to stretch your shoulder
Anti-inflammatory medications: These can be helpful to treat both the pain and the inflammation. Discuss with Dr Walcott medication and dosing.
Corticosteroid Injection: Ultrasound-guided injections of corticosteroids directly into the shoulder joint can provide relief from pain and inflammation.
Once in the Frozen stage
Physical Therapy: Once the pain from stretching the shoulder has subsided, physical therapy starts. Physical therapy as well as a diligent home stretching program is important for regaining a full shoulder range of motion.
Surgical
Treatments
The vast majority of patients get better without surgery. When stiffness persists for much longer than expected and does not improve with an aggressive stretching program, surgery may be an option. Surgery is only an option in the thawing phase. Surgical treatment for frozen shoulder is arthroscopic capsular release. This involves going into the shoulder through small incisions with the arthroscope and cutting the thickened capsule. Physical therapy starts the day following surgery.