Omanghana
Frozen shoulder, medically known as adhesive capsulitis, is a painful condition that causes increasing stiffness and restricted movement in the shoulder joint.
It develops when the capsule of connective tissue surrounding the shoulder becomes inflamed, thickened and tight. As space within the joint decreases, ordinary movements such as dressing, bathing or reaching overhead can become extremely difficult.
The Important Range-of-Motion Clue
One of the strongest clinical signs of frozen shoulder is the loss of both active and passive range of motion.
Active range of motion describes how far a person can move the affected arm without assistance. Passive range of motion refers to how far a healthcare professional can move the relaxed arm during an examination.
With frozen shoulder, movement is restricted in both situations. The patient cannot move the shoulder normally, and another person also cannot move it through its usual range. External rotation—turning the arm outward is often particularly limited.
By comparison, some rotator cuff injuries can significantly impair active movement because of pain or weakness while leaving passive movement relatively preserved. This is only a general distinction, however, and not a definitive home test. Rotator cuff injuries, arthritis and other conditions may also cause considerable pain and stiffness.
A clinician must assess the shoulder to determine the underlying cause. The arm should not be forcibly moved to test its limits.
The Three Stages of Frozen Shoulder
Frozen shoulder usually develops gradually and progresses through three overlapping stages. The duration of each phase varies considerably between patients.
1. The Freezing Stage
The freezing stage can last from approximately six weeks to nine months.
During this period, the person usually develops persistent, dull or aching pain that gradually becomes more severe. The discomfort may worsen with movement and is frequently more intense at night, sometimes making it difficult to sleep on the affected side.
As the pain increases, the shoulder begins to lose mobility. Reaching above the head, behind the back or across the body may become progressively harder.
2. The Frozen Stage
The frozen stage commonly lasts several months, although some people experience it for up to a year.
Pain may stabilize or begin to improve, but stiffness becomes the dominant problem. The shoulder can feel mechanically restricted, making routine activities difficult or impossible.
A person may struggle to fasten a bra, tuck in a shirt, wash or comb their hair, reach into a cupboard or extend an arm for a seatbelt. Work, driving and household responsibilities may also be affected.
3. The Thawing Stage
During the thawing stage, the tight shoulder capsule gradually relaxes and movement begins to improve.
Recovery can take anywhere from several months to two years or longer. Some people regain normal or nearly normal movement, but the rate of improvement differs from one patient to another.
Overall, frozen shoulder may persist for months or even years, although symptoms usually improve over time. The American Academy of Orthopedic Surgeons notes that recovery can sometimes take up to three years. AAOS
Who Is More Likely to Develop It?
Frozen shoulder most commonly affects adults aged 40 and older, particularly women. It may occur without an identifiable cause, but several factors can increase the risk.
Prolonged shoulder immobility is one of the major risk factors. The condition may develop after surgery, a fracture, a rotator cuff injury or a stroke when movement of the arm has been restricted.
Diabetes is also strongly associated with frozen shoulder. People with diabetes may experience more severe stiffness and a longer recovery period.
Other associated conditions include an overactive or underactive thyroid, cardiovascular disease and Parkinson’s disease.
How Frozen Shoulder Is Diagnosed
A doctor or physiotherapist will normally ask about the symptoms and examine both active and passive shoulder movement. The pattern of restricted motion can provide important evidence of adhesive capsulitis.
Imaging is not always necessary to diagnose the condition. However, an X-ray may be used to check for arthritis or other bone-related problems, while an MRI scan or ultrasound may help identify a rotator cuff tear or another soft-tissue injury.
People should seek medical assessment when shoulder pain and stiffness persist, interfere with sleep or make it difficult to move the arm. NHS
Frozen shoulder can be frustrating and slow to resolve, but treatments such as appropriate pain management and professionally guided physiotherapy can help control symptoms and gradually restore movement.
Source: Omanghana
