Frozen Shoulder

1. Freezing stage: In the initial phase, there is a spontaneous onset of pain and stiffness which can be worse at night. It can last about 2-9 months. Spontaneous onset of shoulder pain that increases, and range of motion gradually decreases.
2. Frozen stage: Severe pain and stiffness making shoulder movements challenging, but there is less pain than in the initial phase. This stage can last 4-12 months.
3. Thawing stage: Gradual improvement in range of motion slowly improves as the shoulder begins to recover and pain begins to lessen. This phase can last 5-24 months.

Full recovery may take years, but the extended period of pain and limited mobility can have a profound impact on daily life, hindering routine tasks like driving, bathing, dressing, as well as work and recreational activities. Frozen shoulder significantly reduces quality of life due to the prolonged discomfort and disability associated with the condition.

1. Pain: It usually begins with a dull or aching pain in the outer shoulder area and can sometimes extend into the upper arm.
2. Stiffness: As the condition progresses, the range of motion in the shoulder decreases, making it harder to lift the arm or rotate the shoulder.
3. Limited Movement: Activities like reaching overhead or behind the back become difficult or impossible.

The exact cause of frozen shoulder is not always clear. Generally, people with diabetes are more at risk of developing frozen shoulder than people without diabetes. Other factors that may contribute to its development:

1. Prolonged immobility of the shoulder due to trauma, surgery, or other conditions may lead to frozen shoulder.
2. People with heart disease, thyroid disorders, adrenal disease, or Parkinson’s disease are at higher risk.

Dr. Cinque will review your medical history including any underlying diseases that may trigger frozen shoulder. He will inquire about your symptoms and when they began, and any recent shoulder injuries, and the extent of your disability. Dr. Cinque will perform an orthopedic examination to evaluate shoulder movement and reange of motion to assess pain and stiffness. While frozen can often be diagnosed from signs and symptoms, Dr. Cinque will order imaging studies. to rule out other potential causes.

Treatment for frozen shoulder focuses on relieving pain and restoring the shoulder’s range of motion. It may involve:

1. Over-the-counter pain relievers (e.g., ibuprofen or acetaminophen) or prescription medications can help manage pain and inflammation.
2. Physical therapy including exercise, stretching, strengthening exercises guided by a physical therapist are crucial for restoring shoulder movement and improve pain.
3. Corticosteroid injections into the shoulder joint can reduce inflammation and improve mobility. Studies suggest that the early use of intraarticular injections of corticosteroids in patients with frozen shoulder of less than one year is associated with better outcomes. When combined with physical therapy steroid injections offer significant benefits.
4. Hydrodilatation: This involves injecting sterile fluid into the joint to stretch the capsule and improve range of motion.
5. Extracorporeal Shockwave Therapy: This is a non-invasive treatment that uses high energy sound waves to help heal frozen shoulder by breaking up adhesions or scar tissues. It is used to relieve pain and improve function, shorten healing time and allow for a quicker return to daily activities.
6. Surgery: If other treatments are not effective, arthroscopic capsular release surgery may be considered to release the tightened joint capsule. This is typically a last resort.