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Frozen shoulder

Frozen shoulder is when the shoulder is

painful and loses motion because of

inflammation

Frozen shoulder, also known as adhesive

capsulitis

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Causes

The capsule of the shoulder joint has ligaments thathold the shoulder bones to each other. When thecapsule becomes inflamed, the shoulder bones areunable to move freely in the joint.

Most of the time there is no cause for frozen shoulder.Risk factors include:

Cervical disk disease of the neck

Diabetes

Shoulder injury

Shoulder surgery

Open heart surgery

Thyroid problems

http://www.nlm.nih.gov/medlineplus/ency/article/001214.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002950.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002950.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001214.htm

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Symptoms

The main symptoms are:

Decreased motion of the shoulder

Pain

Stiffness

Frozen shoulder without any known cause startswith pain. This pain prevents you from movingyour arm. Lack of movement leads to stiffness

and then even less motion. Over time, youbecome unable to do movements such asreaching over your head or behind you.

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Tests and diagnosis

Hands up.Raise both your hands straight up in the air,like a football referee calling a touchdown.

Opposite shoulder.Reach across your chest to touchyour opposite shoulder.

Back scratch.Starting with the back of your handagainst the small of your back, reach upward to touchyour opposite shoulder blade.

Frozen shoulder can usually be diagnosed from signsand symptoms alone. May suggest imaging testssuch as X-rays or an MRIto rule out other structuralproblems.

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Lifestyle and home remedies

Continue to use the involved shoulder and

extremity in as many daily life activities as

possible within the limits of your pain and

range-of-motion constraints. Applying heat or

cold to your shoulder can help relieve pain.

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Treatment

Most frozen shoulder treatment involves controlling shoulder pain and preserving as much range ofmotion in the shoulder as possible.

MedicationsOver-the-counter pain relievers, such as aspirin and ibuprofen (Advil, Motrin, others), can helpreduce pain and inflammation associated with frozen shoulder. In some cases, your doctor mayprescribe stronger pain-relieving and anti-inflammatory drugs.

TherapyA physical therapist can teach you stretching exercises to help maintain as much mobility in yourshoulder as possible.

Surgical and other proceduresMost frozen shoulders get better on their own within 12 to 18 months. For persistent symptoms,your doctor may suggest: Steroid injections.Injecting corticosteroids into your shoulder joint may help decrease pain and improve

shoulder mobility.

Joint distension.Injecting sterile water into the joint capsule can help stretch the tissue and make it easierto move the joint.

Shoulder manipulation.In this procedure, you receive a general anesthetic so you'll be unconscious and feelno pain. Then the doctor moves your shoulder joint in different directions, to help loosen the tightenedtissue. Depending on the amount of force used, this procedure can cause bone fractures.

Surgery.If nothing else has helped, you may be a candidate for surgery to remove scar tissue and adhesionsfrom inside your shoulder joint. Doctors usually perform this surgery arthroscopically, with lighted, tubularinstruments inserted through small incisions around your joint.

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Possible Complications

Stiffness and pain continue even with therapy

The arm can break if the shoulder is moved

forcefully during surgery

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Outlook (Prognosis)

Treatment with physical therapy and NSAIDswill usually restore motion and function of theshoulder within a year. Even untreated, the

shoulder can get better by itself in 24 months. After surgery restores motion, you must

continue physical therapy for several weeks ormonths to prevent the frozen shoulder fromreturning. Treatment may fail if youcannot keep up with physical therapy.