Everything You Need to Know About Frozen Shoulder

Frozen shoulder (also known as adhesive capsulitis) is a frequent condition that causes discomfort, stiffness, and loss of normal range of motion in the shoulders. It normally begins gradually, worsens with time, and finally resolves within one to three years. Understanding frozen shoulder, including its symptoms, causes, and treatment options is crucial for effective management and relief. This comprehensive guide will cover everything you need to know about frozen shoulder treatment, including insights from shoulder pain specialists in Kolkata.

What is a Frozen Shoulder?

A frozen shoulder is a condition that restricts the shoulder’s range of motion. The shoulder capsule, a connective tissue that surrounds the shoulder joint, thickens and tightens, leading to pain and limited movement. The condition often affects people between the ages of 40 and 60 and is more common in women.

Symptoms of Frozen Shoulder

The primary symptoms of a frozen shoulder include:

1. Pain: Dull or aching pain in the outer shoulder area and upper arm.
2. Stiffness: Difficulty in moving the shoulder, especially with overhead or reaching movements.
3. Limited Range of Motion: Inability to perform everyday activities, such as reaching behind your back or lifting objects.

Causes and Risk Factors

The exact cause of frozen shoulder is unknown, but several factors may increase the risk of developing the condition:

1. Injury or Surgery: A shoulder injury, surgery, or immobilization can lead to the development of a frozen shoulder due to prolonged inactivity of the shoulder joint.
2. Medical Conditions: People with diabetes are at a significantly higher risk of developing a frozen shoulder. Other conditions that may increase the risk include thyroid disorders (both hyperthyroidism and hypothyroidism), cardiovascular disease, Parkinson’s disease, and stroke.
3. Middle-aged Adults: People between the ages of 40 and 60 are more likely to develop frozen shoulder. It is rare in younger individuals.
4. Women: Women are more prone to frozen shoulders than men. The exact reason for this gender difference is not well understood.
5. People with Sedentary Lifestyles: A lack of physical activity can contribute to the stiffness and immobility associated with a frozen shoulder.

Diagnosis of Frozen Shoulder

1. Physical Examination: A thorough medical history and physical examination by a shoulder pain specialist are essential for diagnosing a frozen shoulder. The doctor will assess your range of motion and identify any limitations or pain during movement.
2. Imaging Tests: The doctor may recommend imaging tests, such as X-rays, MRI, and ultrasonography, to find the root cause of the pain and to rule out other potential conditions affecting the shoulder.

Frozen Shoulder Treatment Options

Effective frozen shoulder treatment focuses on relieving pain and restoring motion. Here are the common treatment options:

1. Physical Therapy

Physical therapy is a vital part of frozen shoulder treatment. A physical therapist will guide you through exercises, designed to improve flexibility and strength. Regular stretching and range-of-motion exercises can help reduce stiffness and increase shoulder mobility.

2. Medications

Some pain relievers, such as ibuprofen or acetaminophen, can help manage pain. In some cases, a doctor may prescribe stronger pain medications or anti-inflammatory drugs to reduce pain and swelling. However, it is important not to take any medication without a doctor’s permission, as excessive use of painkillers can harm your liver and kidneys.

3. Steroid Injections

Corticosteroid injections into the shoulder joint can provide significant pain relief and reduce inflammation. However, it is important to be aware of the potential cons of steroid injections, including the risk of weakening tendons, potential infection, and long-term damage to the joint. For that reason, doctors do not recommend steroid injections.

4. Hydrodistension

Hydrodistension, also known as hydrodilatation, involves injecting sterile fluid into the shoulder joint to expand and stretch the shoulder capsule, which can improve the range of motion and reduce pain. This procedure is usually performed under local anaesthesia and may be guided by ultrasound to ensure accuracy. It can be particularly beneficial for patients who have not responded well to other treatments, providing significant relief and aiding in faster recovery.

5. Denervation or Neurolysis

Denervation, also known as nerve ablation or neurolysis, is a procedure used to alleviate shoulder pain by targeting specific nerves responsible for transmitting pain signals. In the shoulder, three primary nerves are commonly targeted for denervation: Suprascapular Nerve, Axillary Nerve, lateral pectoral nerve. This technique involves using heat, chemicals, or radiofrequency to disrupt the nerve function, providing relief from chronic pain. Denervation can be particularly beneficial for individuals who have not responded to Hydrodistension.

6. Manipulation under Anesthesia

In this procedure, performed under general anesthesia, the doctor manually moves the shoulder to break up adhesions and improve mobility. This option is usually considered when other treatments have not been effective.

7. Radiofrequency (RF) Ablation

Radiofrequency (RF) ablation can be used in the treatment of a frozen shoulder. This technique can help alleviate pain by targeting specific nerves responsible for transmitting pain signals. Cooled RF ablation, an advanced form of this procedure, has been found to be particularly effective for frozen shoulder. This method enhances the effectiveness of the treatment, offering longer-lasting relief and better functional recovery.

8. Regenerative Therapy

Regenerative therapy is particularly effective in treating ligament injuries, it also shows promise in enhancing recovery and restoring mobility in cases of frozen shoulder. Stem cell therapy and Platelet-rich plasma (PRP) are two types of regenerative therapy.

1. Stem Cell Treatment: Stem cell treatment is an innovative approach for managing frozen shoulder. In this procedure, stem cells are typically harvested from the patient’s bone marrow or adipose (fat) tissue. These cells are then processed and implanted into the affected shoulder joint under imaging guidance for precise placement. The stem cells help repair damaged tissues, improve joint function, and reduce pain.
2. PRP Treatment: Platelet-Rich Plasma (PRP) therapy is another promising treatment for frozen shoulder. PRP involves drawing a small amount of the patient’s blood, concentrating the platelets rich in growth factors, and then implanting the PRP into the affected shoulder joint under imaging guidance to promote tissue repair and reduce inflammation. PRP therapy aims to accelerate the healing process, improve joint function, and alleviate pain. This is an attractive option for patients seeking alternatives to surgery or those who have not experienced relief from traditional treatments.

9. Surgery

Surgery is rarely needed for a frozen shoulder. However, in severe cases, arthroscopic surgery may be performed to remove scar tissue and adhesions. This procedure can significantly improve shoulder movement and reduce pain.

Preventing Frozen Shoulder

While it may not always be possible to prevent a frozen shoulder, certain measures can reduce the risk:

1. Stay Active: Regular physical activity can help maintain shoulder flexibility and strength.
2. Regular Exercise: Incorporate shoulder exercises into your routine to keep the joint mobile and prevent stiffness.
3. Avoid Immobilization: If you have a shoulder injury or surgery, follow your doctor’s advice on gentle movements and exercises to prevent stiffness.
4. Manage Underlying Conditions: Controlling medical conditions like diabetes and thyroid disorders can lower the risk of developing a frozen shoulder.

By staying proactive with these preventative measures, you can help maintain shoulder health and reduce the likelihood of developing a frozen shoulder.

Choosing the Best Doctor for Shoulder Pain

Finding the right specialist for shoulder pain treatment is crucial. However, selecting the right specialist is essential for effectively managing shoulder pain, particularly with conditions like a frozen shoulder. If you’re in Kolkata and need expert care, Dr. Krishna Poddar is a highly skilled specialist with extensive experience in pain management and anaesthesiology. Dr. Krishna Poddar provides personalized treatment plans designed to address each patient’s unique needs.

The Kolkata Pain Relief Clinic is a premier facility for shoulder pain treatment in Kolkata. The clinic is equipped with state-of-the-art technology and offers advanced treatment options for a range of shoulder conditions, including frozen shoulder.

Conclusion

Frozen shoulder can be a painful and debilitating condition, but with proper diagnosis and treatment, most people recover fully. If you are experiencing shoulder pain, consult a shoulder pain specialist to get the best care and start your journey toward recovery. For those in Kolkata, several top-notch clinics and specialists are available to provide expert care and support. Visit a shoulder pain clinic in Kolkata to receive comprehensive treatment tailored to your needs. Stay proactive about your shoulder health and seek professional help when needed.