It is also k/a adhesive capsulitis whose cause is unknown which causes inflammation of capsule and synovium resulting in painful restriction of active and passive movements of shoulder joint. It commonly affects individuals between 40-60 years of age.
Though causes are unknown but various conditions do contribute in developing frozen shoulder like diabetes mellitus, rotator cuff tears, shoulder impingement, biceps or deltoid tendinitis.
STAGES OF FROZEN SHOULDER
1. FREEZING STAGE-
a. Lasts for 2-9 months.
b. Severe shoulder pain typically worse at night.
c. Difficulty in sleeping on affected side.
2. FROZEN STAGE-
a. Lasts 4-12 months
b. Pain starts settling with characteristic loss of joint range of motion.
3. THAWING STAGE-
a. Patient experiences gradual return of ROM and is usually self limiting resolving in 1-3 years.
WHAT CAN FROZEN SHOULDER FEELS LIKE?
• Pain and stiffness in and around the shloulder.
• Nature of pain is generally deep aching continuous type.
• Restricted range of movement.
• Sharp pain usually at the end of movements.
• Tenderness and swelling around the shoulder joint.
• Difficulty in elevation, combing hair, reaching hip pocket, taking the hand back, doing activities of daily living.
• Wakening at night because of the pain.
• Inability to sleep on the affected side.
• Weakening of muscles around the shoulder like deltoid, supraspinatus, infraspinatus, subscapularis, teres minor resulting in decreased functionality.
MANAGEMENT OF FROZEN SHOULDER
• Initial management includes education and reassurance. Patients should be encouraged to keep themselves active despite of pain. All patients should receive active physiotherapy for management and coming back to near normal function.
• In case swelling is present then cold packs must be preferred. Otherwise start with hot fomentation.
• Begin with the pain relief modality that is wireless pro (burst mode), TENS, IFT.
• Ultrasound therapy helps in heating the tissues and also increasing the flexibility of the contracted soft tissues.
• Sustained home stretching techniques should be done to facilitate muscle relaxation and reduce spasms.
• Gentle oscillations of the arms has to be initiated.
• Attempts should be made to increase the joint ROM beyond the painful limits.
• Physiotherapist can help with mobilizations.
• Muscle releases should be carried out by various means like matrix therapy, cupping, IASTM etc.
• Pendular exercises are very helpful for generating rhythmic muscular contractions and relaxations.
• Various exercises like arm squeeze, wall ladder, pulley exercise, PNF patterns all help in regaining the lost range of motion and build up muscle strength.