ADHESIVE CAPSULITIS (FROZEN SHOULDER)

Frozen shoulder is caused by inflammation of the shoulder joint capsule and surrounding tissues. Middle-aged people and Women have a higher incidence.  Because inflammation and pain induce shoulder muscles guarding and tightness, which affect the normal movements. In a vicious cycle, the soft tissues become tighter, which causes even more pain in movement and even gradual onset of joint displacement. In severe cases, one cannot lift the arm above 90 degrees and have intense pain and stiffness.

The actual underlying cause of adhesive capsulitis is unknown, but the history of trauma, long term overuse (wrong lifting posture), and very tight shoulder muscles limiting normal shoulder mobility may increase the incidence of frozen shoulder. Moreover, the inflammatory process often progresses very slowly. If patients didn’t treat it properly, the shoulder joint may still actively inflame even after a year.

Stroke, cervical pathology, breast cancer or previous upper limb fractures or trauma which may affect shoulder muscle strength and normal movements

The most obvious symptoms are shoulder pain and stiffness. The pain greatly disturbs sleep and daily activities like combing hair, dressing, or scratches your back.

Frozen shoulder can be divided into three stages:

(1) Acute Pain Period: Shoulder pain is very intense that often disturbs sleep. The anti-inflammatory drug may not help so much. Sometimes the pain diffuses across the whole shoulder and scapula region. It may not be easy to point the tender spot accurately.

(2) Freezing period: In this subacute stage, patients may start to feel the shoulder gradually becomes stiff in certain directions and angles, but the pain mildly decreases.

(3) Rehab period: The freezing of the shoulder gradually resolves, the joint mobility and pain are also improved. At this stage, the shoulder undergoes a very long recovering period; however if the problems are not properly treated, there will be many complications and limitations in daily activities.

The treatment principle of frozen shoulder is to take corresponding treatment measures for different periods of frozen shoulder:

1. Early phrase of rehab

Using acupuncture, ultrasound, electrophysical therapy, hot and cold therapy, or any other physiotherapy treatment to relieve the pain, so as to improve the blood circulation and reduce local inflammation.

2. Frozen Period of rehab

Pain is often caused by joint dysfunction, and the treatment aim during this period focuses on restoring joint function. The mobilization exercise can reduce joint stiffness, increases the range of shoulder movement, and restore normal joint function.

3. Remodeling phrase of rehab

The main purpose is to alleviate the residual symptoms and to continue functional training and muscle strengthening. Also, it is essential to restore normal functions of previously atrophic muscles to achieve comprehensive rehabilitation and prevent a recurrence.

• Avoid concentrating or reusing the same shoulder when working or doing housework. Try to use your shoulder alternately
• Strengthen the shoulder stabilizing muscles and improve posture
• Maintain good flexibility and strength of the soft tissues around the shoulder

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