Frozen Shoulder Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Frozen shoulder is also known as adhesive capsulitis. This term is generally used to describe a shoulder that feels stiff and painful.
Based on the American Elbow and Shoulder Surgeons, this condition is used to describe conditions of limited movement of the shoulder that appear without a clear cause or without any intrinsic abnormalities in the shoulder. The limitations of a movement referred to are both active and passive.
In addition, based on the American Academy of Orthopedic Surgeons, frozen shoulder is known to be a condition with varying degrees of severity. This condition is characterized by a gradual process of limitation of active or passive shoulder movement. In fact, on the other hand, there was no interference with the radiological examination apart from the problem of osteopenia (a condition in which the bones decrease in density but has not yet become a condition of osteoporosis).
Symptom
There are several symptoms that appear in frozen shoulder, such as:
- Shoulder pain generally occurs when the shoulder has to move and in the early days of the disease appears.
- Pain at night which can interfere with sleep quality and make it difficult to lie on the affected side.
- Restricted shoulder movement.
Reason
Frozen shoulder occurs when the flexible tissue that surrounds the shoulder joint ( shoulder capsule ) becomes thickened and inflamed. However, the exact cause of the thickening and inflammation is unknown.
However, there are several things that are thought to be triggered, namely:
- Idiopathic (a disease condition whose cause is unknown).
- Trauma, for example due to surgery to the shoulder, torn tendon, or fracture of the upper arm.
- Immobilization, for example due to old surgical scars such as thoracic and cardiovascular surgery, or neurosurgery.
- Metabolic/endocrine diseases, for example due to diabetes, autoimmune diseases, and thyroid disease.
- Nerve problems, for example due to stroke or Parkinson’s Disease.
- Heart problems, such as hypertension or cardiac ischemia.
- Medications, for example consumption of protease inhibitors, anti-retroviruses, immunizations, or fluoroquinolones.
- Other causes, such as hyperlipidemia (high cholesterol), or cell malignancy.
Diagnosis
In determining the diagnosis of frozen shoulder, the doctor will ask various questions to find out the symptoms that are felt. Then a physical examination will be carried out, especially around the movement of the shoulder.
Shoulder movement in all directions will be assessed actively and passively. Active shoulder movement is assessed based on your own shoulder movement. Meanwhile, passive movements are assessed based on the movements made by other people who move your shoulders.
This is done to assess the presence of pain or limitation of motion. Supporting examinations, generally through X-ray or MRI imaging and Ultrasound. The goal is to help rule out other possible causes.
Treatment
In general, the symptoms that appear in a frozen shoulder will subside over time. However, it takes a fairly long period of time (up to 3 years).
The goal of treatment is to manage pain and limited range of motion. Treatment measures that can be taken are:
- taking anti-inflammatory drugs or NSAIDs to treat pain and inflammation
- steroid injection in the shoulder joint
- physiotherapy, in the form of using special physical exercises to help overcome movement limitations
- external rotation-passive stretch
- extracorporeal shockwave therapy (ESWT)
- surgery, recommended if other treatment methods do not improve the condition
Prevention
There are no specific steps that can prevent frozen shoulder because the triggers are also very diverse and unpredictable. Maintaining the strength and flexibility of the muscles around the shoulder with the right exercises and stretches will help condition the strength of your shoulder joint.