What is Frozen Shoulder? (ફ્રોઝન શોલ્ડર) (shoulder pain)

Shoulder pain starts with advancing age and is more common after 50-55 years of age. Many people have pain in one or both shoulder and there is problem in movement as well which restricts daily activities. The main cause of this could be Frozen Shoulder.

Understand what is Frozen Shoulder from expert Dr. Pranav Patel.


What is Frozen Shoulder?

The shoulder joint is a synovial joint. It has a layer of synovium. There is a capsule which covers the synovium. The capsule can be called as a cover to the joint. There are specific muscles which help in movement of the shoulder joint and these muscles are in close proximity to the capsule. when there is inflammation in the capsule, the capsule sticks to the adjacent muscles and the shoulder is frozen or in other words stuck. There is pain in the shoulder and movements are restricted.

What are the main symptoms?

1. Pain in the joint.
2. Difficulty in movement of the shoulder.
3. Difficulty in wearing shirt.
4. Difficult to manage hair in women.
5. Difficult to take care of back while bathing.
6. Difficulty in day to day activities.

Causes of Frozen Shoulder. 


Frozen shoulder is of two types.

1. Primary Frozen Shoulder. 
2. Secondary Frozen Shoulder. 

Primary Frozen Shoulder: (adhesive capsulitis)
Primary Frozen Shoulder is caused due to Diabetes. Those patients who have diabetes have problem in one or both shoulders. Affection of the shoulder joint is irrevelant to the control of diabetes. Many a times Diabetes is detected after the patient gets Frozen shoulder.

Secondary Frozen Shoulder: 
There are many diseases of the shoulder which lead to Secondary Frozen Shoulder. For e.g.
Rotator cuff tear (tear in muscles of the shoulder)
Arthritis (degenerative process of the shoudler)
Biceps tendinosis (inflamation of the biceps tendon)
And many more.


Management of Frozen Shoulder. 


There is a major difference in the treatment of Primary and Secondary Frozen Shoudler.

In Primary frozen shoulder, a good sugar control and specific supervised physiotherapy gives good results. Physiotherapy needs to be done for longer periods in many cases for upo 1.5 to 2 months. Anti-inflammatory medicines are required which deals with pain and inflammation. Physiotherapy then helps in improvement of movement. In cases where there is no improvement of movement even after 1 month of regular physiotherapy, they require specific injections into the joint or sub-acromial space. These injections have targeted action on the surrounding inflammation. Those patients who do not get any benefit from injections are subjected to Arthroscopic Surgery.

 

Physiotherapy and medications have main role in Primary Frozen Shoulder, while in Secondary Frozen shoulder different kinds of protocols are to be followed in physiotherapy and many a times surgery is required depending upon the cause of secondary frozen shoulder.

The first and foremost treatment protocol for Secondary Frozen Shoulder is definitive diagnosis. If there is Rotator Cuff Tear and we do physiotherapy without the knowledge of type, site and size of tear it can be detrimental for the shoulder and will make the simple surgery complicated. For secondary frozen shoulder sometimes MRI of the shoulder becomes must. MRI provides the specific diagnosis and hence guides in terms of management of the disease.

Frozen Shoulder be it Primary or Secondary can be managed with Arthroscopy and gives good results. When surgery is performed by arthroscopy there are 2-3 stitches and recovery is faster than open surgery. Patient can be discharged from the hospital in 24 hours of surgery.

In a nut shell if u have Frozen Shoulder, do meet your doctor and gain knowledge of the cause of your Frozen shoulder, type (Primary or Secondary) and follow his advice.

Dr Pranav Patel 
M.S. Ortho
Fellow in Arthroscopy and Sports Medicine 
Fellow in Sports Rehabilitation

Sankalp hospital, vasna road, 
Near Kalyan party plot,  Vadodara, Gujarat, India 

+91 96648 86737

This blog is for information purposes only, kindly consult your Doctor before starting any treatment.