Shoulder ‘Freeze’ can be Treated

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Category: Soft Tissue Rheumatism Articles Published on Sunday, 12 December 2004 Written by Yong Tsai, MD
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For the past seven years, Jack, as we’ll call him, has been making wine in his own home. Almost daily, he carried a barrel weighing approximately 40 pounds, up and down steps several times. This never bothered him until six months ago, when he experienced pain in his right shoulder and arm.

He began to find it difficult to comb his hair, reach up to get something in an overhead cabinet or reach behind him to scratch the opposite shoulder. The pain and restricted movement of his right shoulder became progressively worse.

Diagnosis of these symptoms was rather straightforward. Jack was suffering from rotator cuff tendonitis. In time, due to inflammation of these tendons and prolonged immobility, he could develop adhesive capsulitis – in layman’s terms, a frozen shoulder. The condition often follows an injury or inflammation that keeps a person from moving his arm for a prolonged period of time.

The shoulder is a ball-and-socket joint, and muscles, tendons, and the joint capsule hold the ball and socket firmly in pace. When you raise your arm, the sleeve-like structure gets tighter, when you lower your arm, the sleeve loosens up. Daily pushing, pulling, and reaching generally keeps the sleeve operating normally. However, the sleeve can form tiny adhesions between the shoulder joint capsule and head of the humerus (upper part of the arm) and between the folds of the capsule. As a result, the joint capsule beings to constrict, and eventually all motion is restricted. This condition is a frozen shoulder, and immobility – due to bursitis or injury – is a factor in half of all cases.

The key symptom of a frozen shoulder is limitation of shoulder movement in all directions. The person will experience pain trying to move his arm in any direction. A frozen shoulder also has been linked with diabetes, cervical spine, degenerative disease, hyperthyroidism, hear disease, and chronic lung disease. The condition occurs chiefly in those between the age of 40 and 70 and twice as often in women than men.

Non-steroidal, anti-inflammatory drugs are the first line of treatment, along with local heat or cold treatment and a program of passive stretching exercises – the real key to recovery, experts agree.

The object is to stretch the shoulder capsule beyond its limited range of movement through repetitive and self-induced passive exercise. Most patients who faithfully cooperate with the exercise program recover in four to six months. Those who show no improvement after six to eight weeks, however, are referred to a specialist for manipulation under anesthesia, which generally results in rapid movement.

Full restoration of shoulder mobility, however, still requires continuing stretching exercises for several weeks. It’s imperative you seek treatment early – before significant adhesions develop.

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