Frozen shoulder, that limits the movement of shoulders, is a chronic condition that needs immediate medical treatment. Although many shoulder diseases involve pain and loss of movement/motion, frozen shoulder is commonly caused by inflammation (swelling, pain and irritation) of the tissues surrounding the joint and it more painful.
According to John Hopkins’ hopkinsmedicine.org, the condition results from gradual loss of movement in the shoulder (glenohumeral) joint. ‘This joint consists of a ball (the humeral head) and socket (the glenoid). Normally it is one of the most mobile joints in the body. But when the shoulder is frozen, the joint has become stuck and its movement is limited.’
So, what should one do?
When this occurs, the first thing to do is to consult your physician who will advise a few tests like X-ray to rule out any other cause for the condition, said Dr Tina Jain, Assistant Manager-Quality and Physiotherapy, Bhatia Hospital Mumbai.
Types of frozen shoulder
There are two types of frozen shoulder.
*Primary adhesive capsulitis: Reason is idiopathic or unknown cause. According to hopkinsmedicine.org, inflammation of the muscles and/or tendons, as with rotator cuff tendinitis or bursitis, can also cause the shoulder joint to become frozen.
*Secondary adhesive capsulitis is caused by stiffness occurring due to shoulder injury, surgery, or prolonged immobility.
“Secondary frozen shoulder is more likely to occur in people working from home due to long hours of sitting without stretching and bad posture with a hunch back. It is advisable to stretch the upper neck, head, shoulder and upper back to avoid this. Also, early treatment and mobilisation of the shoulder should be done under the supervision of a physiotherapist to avoid frozen shoulder,” said Dr Jain.
However, Dr Garg feels that sometimes “it is not directly associated with people’s work from home schedule”, it is more a result of restricted physical activities, and lack of adequate body movement, which can aggravate the severity.
Difference between stiff and frozen shoulders
In stiff shoulder, the range of motion of the shoulder is restricted due to diverse reasons including recent bone injuries, tumour, arthritis, Mal United fracture whereas frozen shoulder is one of the reasons for stiff shoulder, more associated with ageing and diabetes which cause inflammation in shoulder’s capsule resulting in a restricted range of motion and pain, described Dr Lokesh Garg, Associate Consultant, Musculoskeletal/Orthopedic Oncology, Dharamshila Narayana Superspeciality Hospital.
There are two types of treatment, one is to increase the motion which can be done through physical therapy to move the patient’s arm to stretch the capsule, while the other is to reduce pain through anti-inflammatory medications.
“The physical therapist will teach certain exercises to be done at home by the use of a wand or overhead pulley. Heat, ultrasound or electrical stimulation can also be used. The therapist will demonstrate a stretching program that you should do at least once or twice a day. These exercises include the use of a cane, a home pulley system and an elastic cord to increase motion of the shoulder,” Dr Jain explained.
Range of motion exercises, strengthening exercises, adequate nutrition are suggested for recovery and prevention are recommended, said Dr Garg.