The shoulder is comprised of three bones: the humerus, scapula and calvicle. The shoulder is a very mobile joint and receives minimal stability from the bony structures. The soft tissue of the shoulder, including the rotator cuff muscles and joint capsule, function to help provide stability to the most mobile shoulder joint.
Shoulder being the most mobile joints is also prone for most types of injuries and degeneration. It results in chronic pain and limitation of movement.
Frozen shoulder is when the shoulder is painful and loses motion because of inflammation.
The joint capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time there is no cause for frozen shoulder.Degenerative disease and overuses is the common in shoulder pain along with some inflammatory diseases.
Risk factors :
- Cervical disc disease of the neck.
- Shoulder injury.
- Shoulder surgery.
Symptoms of Frozen Shoulder:
- Decreased motion of the shoulder
Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. The lack of movement leads to stiffness and eventually less motion of the shoulder. Over time, you are unable to perform activities such as reaching over your head or behind you.
Diagnosis of Frozen Shoulder:
Based on patients symptoms and examination (movements restriction) of your shoulder, x-rays or MRI of the shoulder (as per requirement) diagnosis will be given.
Shoulder pain with limited range of movements
- Osteoarthritis of joint
- Capsulitis of joint
- Rotator cuff syndrome
- Osteoarthritis of Acromio-clavicular joint
Shoulder pain without limited range of movement
- Impingement syndrome
- Subacromial bursitis
Shoulder pain without limited range of movement due to problem outside shoulder
- Shoulder instability (Habitual dislocation)
- Cervical Radicular syndrome
- Brachial plexus syndrome
- Intrathoracic tumor / cancer / Metastases
Treatment are in two forms as:
1. Conservative Frozen Shoulder Treatment :
- Analgesics, Muscle relaxants, Local applications.
- Exercise, Physiotherapy.
- Local application of Hot & Cold fomentation.
2. Interventional Management Frozen Shoulder Treatment:
When conservative management is not giving satisfactory outcome and there is no indication of surgical management, Interventional therapy is the best choice.
Following interventional procedures can be done
- Intra-articular Steroid injection
- Suprascapular nerve block
- Intra-articular acromio-clavicular steroid injection
- Cervical Epidural analgesia
- Injection of Subacromial Bursitis
- Trigger point injection
- Intramuscular stimulation (IMS) markedly reduce pain.
- Pulse Radio-frequency of Suprascapular nerve