Frozen shoulder, medically known as adhesive capsulitis, is a debilitating condition that can affect anyone but is typically present more often in women than men, and is seen more frequently in those who are 50 to 60 years old. The first step in frozen shoulder treatment is often pain management followed by improving mobility. Try these simple treatments at home or with your physical therapist.
During the initial phase of frozen shoulder, the shoulder goes through what is called the “freezing” phase; where severe shoulder pain gets worse at night and the shoulder joint becomes stiffer. Rest and avoiding repetitive motions is one way to manage the pain of frozen shoulders. However, after the initial recovery phase, you should be careful not to completely immobilize your shoulder either. Keeping it moving, even just a bit, can help in the long run.
Frozen shoulder is often caused by a shoulder injury. Using cold therapy can reduce pain by constricting blood vessels and minimizing swelling. Heat can soothe soreness and speed up healing time.
Use cold for the first three days after an injury and then introduce heat. Bringing in the heat too soon can cause bruising or excessive swelling.
Once the initial pain of frozen shoulder has subsided you start implementing stretches and exercises to help the affected arm regain normal range of motion. Specific range of motion exercises will help to regain strength, as well as passive range of motion (when someone else tries to move your arm). Start with these:
However, you should not use a support if you don’t have an underlying shoulder injury. Generally speaking, you should not immobilize your shoulder if you have a frozen shoulder. Movement is key to preventing frozen shoulder.
Pain can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen and may be helpful before or after physical therapy exercises. Make sure to check with your doctor before you start taking a new medication to avoid any unintended medical problems.
Massage can release muscle tension and stiffness in people with frozen shoulder. Considering seeing a professional massage therapist who can press deep into the soft tissue and reach areas that you cannot. Simple self-massage tools are also a great option to work tight ligaments. Learn more in our shoulder massage guide.
Similar to massage, a transcutaneous electrical nerve stimulation (TENS) unit is a small device that uses adhesive patches placed on the body to deliver a small electrical current. It is not painful and thought to reduce pain by either interrupting the pain pathways or by releasing endorphins which are pain-blocking hormones. You can use a TENS unit on the upper arm and shoulder to relieve the pain related to frozen shoulder. It’s an excellent treatment that doesn’t use medication and can be worn just about anywhere.
While many of the symptoms of frozen shoulders can be treated at home, you will need to see a healthcare professional to monitor your condition. Below are treatments that may be used to manage your frozen shoulder.
Physical therapy is a standard treatment in the management of frozen shoulder. The condition causes the shoulder joint capsule to thicken and develop bands of scar tissue called adhesions. After a physical exam, your physical therapist will work to release the tightness through range of motion stretches and exercises. These stretching exercises can continue on your own at home. These shoulder exercises are an incredibly important step in your recovery, so follow your physical therapist’s medical advice and don’t skip out on sessions.
Corticosteroid injections can provide some short-term pain relief from frozen shoulder. Cortisone works best if it is used in the early stages of frozen shoulder. The procedure is done by directly injecting the steroid medication into the shoulder joint. You will need to talk to your doctor to determine if steroid injections are a good fit for your situation.
Hydrodilatation is a procedure where saline and a steroid medication are injected directly into the shoulder capsule. The saline is used to expand the joint and the steroid is used to decrease swelling and pain. This procedure is done by a radiologist with imaging to ensure the fluids go to the right area.
When other treatments are not effective then your doctor may recommend surgery, typically if you have not seen improvement for at least a year with treatment. The main goal of surgery will be to release the shoulder joint and improve movement. The two main types of surgery are arthroscopy and closed manipulation.
Arthroscopic surgery for frozen shoulder involves using small incisions to insert a camera to visualize the shoulder injury. The orthopedic surgeon will cut through tight areas of the joint capsule to release the shoulder. Patients will need physical therapy after surgery to regain range of motion and strength.
This procedure involves administering an anesthetic to put the patient to sleep. Then the doctor moves the shoulder to stretch or tear the tight adhesions and scar tissue. The goal is to improve the patient’s range of motion in their shoulder without surgery.
Very minor symptoms can clear up fairly quickly, but most of the time frozen shoulder is not a condition that resolves overnight. Some cases may take months to years for symptoms to fully heal.
Frozen shoulder causes pain and stiffness in the shoulder and can last anywhere from a few months to years. Treatment at home with heat, stretching, and exercises can loosen tightness and lessen the pain. However, you will need medical treatment from a doctor or physical therapist to fully recover. If you have the beginning symptoms of frozen shoulder, reach out to your doctor to get treatment started, and begin the road to recovery.
Sources:Frozen Shoulder Products
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