Frozen shoulder (also referred to as Adhesive Capsulitis) is a musculoskeletal condition that is marked by painful stiffening of the shoulder joint. Frozen shoulder is caused by constriction or thickening of connective tissue capsule that surrounds the shoulder joint due to ongoing inflammation.

According to latest estimates, the life-time prevalence of developing frozen shoulder in general population is 3 to 5% (1). The symptoms develop gradually in adhesive capsulitis over a course of time and may lead to significant dysfunction in poorly managed cases.

What should you know about Frozen Shoulder?

  • Most cases of frozen shoulder are reported in elderly. The peak age of incidence is 50 to 75 years, suggesting a strong association with physiological aging.
  • Females are 2-3 times more vulnerable to develop frozen shoulder when compared to males (2).
  • Individuals who live a stressful lifestyle are also at risk of experiencing frozen shoulder due to psychosomatic responses by the brain.
  • Not all cases of frozen shoulder are associated with severe assault or injury. It has been statistically proven that more cases of frozen shoulder are seen in clinical practice due to immune dysfunction (or hyperactive healing responses by the immune system) in response to a minor injury or inflammation.
  • The risk of hyperactive immune response is more common in individuals with metabolic or hormonal irregularities (diabetes, thyroid dysfunction etc.)

How to Manage Frozen Shoulder?

A number of therapeutic interventions can be utilized to manage the symptoms of frozen shoulder; such as:

Pain resolution:

  • Anti-inflammatory agents to alleviate acute pain due to inflammation
  • Ice packs or heating pads to reduce stiffness and alleviates pain or discomfort
  • In severe cases, steroid injection are needed to control pain and discomfort

Therapies to restore range of motion:

  • Physical therapy exercises are used to improve the overall range of motion and physical independence of individuals who are suffering from frozen shoulder. Moderate activity under supervision is helpful in restoring blood circulation and resolving edema and stiffness.
  • Soft tissue mobilization: Mobilization of soft tissues and manipulation of joint in hands of an expert chiropractor can significantly control the inflammatory process.
  • Acupuncture therapy is also popularly used by a number of individuals; however, the therapeutic efficacy and potency of acupuncture is highly variable in the setting of adhesive capsulitis.

How to prevent Adhesive Capsulitis or Frozen Shoulder?

Latest research indicates that muscular inactivity is a significant risk factor that may lead to frozen shoulder (and other disorders of this ball and socket joint). Therefore, following interventions are fairly helpful to minimize the risk in susceptible subject.

  • Seek medical supervision for musculoskeletal ailments or injuries in order to maintain steady mobility across the shoulder joint.
  • Perform muscle strengthening and joint stabilizing exercises to minimize the risk of common ailments like tenosynovitis, sprains, and related issues.
  • In case of any active injury (or surgery) of upper limb or chest region, effective physical therapy should be utilized to maintain mobility in the shoulder region.
  • It is strongly recommended to maintain your metabolic and medical health issues under control.

In short, although a history of injury or surgery is strongly associated with the pathogenesis of frozen shoulder, most patients cannot link a memorable incident to the symptomatology in most cases. It generally takes 3-4 days after an acute assault to develop disturbing symptoms of pain and stiffness; however clinical history may vary from person to person.

References:

  1. Page, M. J., Green, S., Kramer, S., Johnston, R. V., McBain, B., Chau, M., &Buchbinder, R. (2014). Manual therapy and exercise for adhesive capsulitis (frozen shoulder). The Cochrane Library.
  2. Brand, R. A. (2008). Loss of scapulohumeral motion (frozen shoulder). Clinical Orthopaedics and Related Research®, 466(3), 552-560.