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FROZEN SHOULDER / CERVICAL PAIN

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What is Frozen Shoulder? 


Frozen shoulder, or adhesive capsulitis, presents as stiffness and discomfort in the shoulder joint due to the constriction of the surrounding capsule. This piece explores the origins, therapeutic modalities, and post-treatment strategies for individuals confronting frozen shoulder typically advances through three stages: freezing, frozen, and thawing. In the freezing stage, individuals encounter escalating pain and stiffness. Subsequently, during the frozen phase, pain may subside, but stiffness remains profound. Ultimately, in the thawing stage, mobility gradually improves albeit sluggishly.

What are Symptoms?

       1.  Pain: The primary symptom is pain in the shoulder joint. The pain may be dull or achy and often feels deep in the shoulder. It may worsen with movement or at night.

  1.   Stiffness: Stiffness in the shoulder joint is a hallmark symptom. This stiffness often leads to a limited range of motion, making it difficult to perform everyday activities such as reaching overhead or behind the back.
  2.   Loss of Range of Motion: As the condition progresses, the range of motion in the shoulder joint decreases. This can make simple tasks such as putting on clothes or reaching for objects challenging.
  3.   Difficulty Sleeping: Many people with frozen shoulders experience difficulty sleeping due to pain and discomfort, particularly when lying on the affected shoulder.
  4.   Progressive Nature: Symptoms of a frozen shoulder typically develop gradually over time. Initially, there may be mild discomfort and stiffness that worsens over several weeks or months

How Do You Know You Have a Frozen Shoulder?

  1. Medical History: Your doctor will likely begin by asking about your symptoms, including when they started, how severe they are, and any factors that may have triggered them. They may also inquire about your medical history and any previous shoulder injuries or conditions.
  2. Physical Examination: During the physical exam, your doctor will assess your shoulder’s range of motion, strength, and stability. They may perform specific maneuvers to check for pain and limitations in movement characteristic of a frozen shoulder.
  3. Imaging Tests: While imaging tests are not always necessary for diagnosing a frozen shoulder, they can help rule out other conditions and provide additional information. These may include:
    • X-rays: X-rays can reveal issues such as arthritis or bone spurs that may be contributing to shoulder pain.
    • MRI (Magnetic Resonance Imaging): MRI can provide detailed images of the soft tissues in and around the shoulder joint, helping to identify inflammation or abnormalities.
  4. Diagnostic Criteria: Frozen shoulder is typically diagnosed based on a combination of symptoms and physical examination findings. The main diagnostic criteria include:
    • Gradual onset of shoulder pain and stiffness
    • Limited range of motion in all directions, particularly external rotation and abduction
    • Symptoms persisted for several months without significant improvement
  5. Differential Diagnosis: Your doctor may also consider other conditions that can cause similar symptoms, such as rotator cuff injuries, arthritis, or shoulder impingement syndrome. They may use imaging tests and other diagnostic tools to differentiate between these conditions.

How do we diagnose?

The etiology of frozen shoulder remains ambiguous, yet several contributing factors have been identified:

  1. Shoulder Joint Trauma: Injuries or accidents may inflict damage to the shoulder, resulting in inflammation and subsequent adhesive capsulitis.

  2. Prolonged Immobilization: Extended periods of restricted shoulder movement, such as prolonged bed rest or post-surgical sling use, heighten the susceptibility to frozen shoulder.

  3. Diabetes: Individuals with diabetes exhibit a heightened risk of developing a frozen shoulder, although the precise mechanism remains elusive.

  4. Underlying Medical Conditions: Certain medical ailments like thyroid disorders, cardiovascular diseases, and Parkinson’s disease have been linked to an increased likelihood of frozen shoulder.

How do we Treat? (H2)

Frozen shoulder treatment aims to alleviate pain and restore shoulder mobility. Common therapeutic approaches encompass:

  1. Physical Therapy: Structured stretching and strengthening exercises enhance shoulder flexibility and mobility.

  2. Pain Alleviation: Over-the-counter pain medications, corticosteroid injections, and nonsteroidal anti-inflammatory drugs (NSAIDs) mitigate frozen shoulder-associated discomfort.

  3. Joint Mobilization: Skilled manual manipulation techniques, performed by healthcare professionals, facilitate the loosening of the shoulder joint and augment the range of motion.

  4. Steroid Injections: In some cases, corticosteroid injections may be used to reduce inflammation and alleviate pain in the shoulder joint. These injections are typically administered directly into the joint under ultrasound or fluoroscopic guidance.

  5. Hydrodilatation: Hydrodilatation, also known as distension arthrography, involves injecting a mixture of sterile saline solution and corticosteroid into the shoulder joint to help stretch and expand the capsule. This procedure can help improve the range of motion in some patients with frozen shoulders.

  6. Surgical Intervention: In severe cases of frozen shoulder that do not respond to conservative treatments, surgery may be considered. Surgical options may include manipulation under anesthesia to break up adhesions and scar tissue, or arthroscopic release to remove scar tissue and release tight structures within the joint.

Post Recovery Care

After treatment for a frozen shoulder, it’s essential to maintain shoulder mobility and prevent recurrence. Continued exercise and stretching can help preserve a range of motion and prevent stiffness. Avoiding repetitive overhead activities and practicing good posture can also minimize the risk of developing a frozen shoulder again.

In addition to frozen shoulder, other conditions such as cervical pain and neck pain can contribute to shoulder discomfort. Seeking cervical pain treatment and cervical pain relief from qualified healthcare professionals is essential for comprehensive pain management.

While slip disc and cancer pain are distinct conditions, they can also manifest with shoulder discomfort as a symptom. If you experience persistent shoulder pain alongside symptoms of Slip disc or cancer, seek prompt medical attention for proper evaluation and treatment.

So, if you’ve been struggling with a frozen shoulder, there’s no need to keep searching for a specialist near you. Dr. Manohar Kanwaria is dedicated to providing top-notch care and helping you find relief from your frozen shoulder symptoms.

 




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