Treating Frozen Shoulder
Frozen Shoulder is something most of us have heard of. Whether family, friend, or co-worker you probably know someone who has suffered from this condition. But what exactly is it? Frozen shoulder (adhesive capsulitis) is a condition of slowly worsening pain and tightness of the shoulder joint. Inflammation of the joint capsule, a connective tissue layer surrounding the joint, slowly worsens causing pain and increasing tightness of the connective tissue. As the capsule tightens, shoulder movement becomes more painful and restricted. The condition goes through 3 phases aptly named, “freezing, frozen, and thawing”. This condition primarily occurs in women over 40 years of age, and can be the result of some type of trauma (a fall), or, in many cases occurs without a preceding injury. The condition does occur in men less frequently, usually following shoulder surgery. The good news is that a frozen shoulder typically improves over time, with or without treatment.
Without treatment, symptoms usually go away in about two years. However proper treatment and home management can help decrease the severity of pain and tightness and speed up the healing process. More than 90% of people with frozen shoulders get better with nonsurgical treatment, such as physical therapy, and anti-inflammatory medicines, such as ibuprofen. If symptoms do not diminish or resolve with time and nonsurgical treatments, surgery may be an option.
Nonsurgical Treatment
There are several nonsurgical treatment options available for frozen shoulder. These include:
Non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, can help decrease swelling and pain.
Physical therapy exercises and stretches are designed to help increase shoulder motion. Manual therapy treatments stretch the joint capsule and create a greater range of motion. A person will be given an exercise program to complete at home in addition to prescribed physical therapy appointments. Progress may be slow. It can take anywhere from weeks to months to see improvement.
Steroid injections are given into the shoulder joint. Steroid injections decrease inflammation in the shoulder joint. Reduced inflammation usually leads to reduced pain and allows for the therapist to stretch the shoulder. It may take a few days before pain decreases, and the pain reduction may last for weeks or be long-term.
Surgery and Procedures
If nonsurgical treatment is ineffective and symptoms persist, there are other options to consider.
Shoulder arthroscopy. This is a common procedure when the physician releases the abnormal, adhesive tissue in the shoulder joint capsule by physically cutting the restrictive tissue fibers. The procedure is designed to increase shoulder range of motion and shoulder movement. After surgery, a patient is usually prescribed physical therapy to assist with restoring full motion and strength of the shoulder.
Manipulation under anesthesia. This is a procedure where the physician physically moves the affected joint in all directions—tearing and breaking up scar tissue in the shoulder joint capsule. This procedure is also followed by physical therapy to assist with the restoration of full shoulder joint function.
The key to success with a frozen shoulder is identifying the problem early and beginning intervention before the joint is fully “frozen”. If you have shoulder pain and tightness that is getting worse, especially if it started for no reason, see a physical therapist right away to get on the right track for proper healing and pain management.