Frozen Shoulder
What is a Frozen Shoulder?
Frozen shoulder, or adhesive capsulitis, is an inflammatory process of the shoulder joint lining and ligaments. The inflammation leads to pain and progressive loss of motion in the shoulder. This condition is more commonly seen in patients with diabetes or thyroid disease, but can happen to anyone, anytime. The cause is unknown, however it can be precipitated by trauma or disuse. Treatments include physical therapy, NSAIDs, cortisone injections, and surgery in refractory cases.
Adhesive capsulitis occurs in a progressive manner in three distinct phases: the inflammatory, or freezing phase, the adhesive, or frozen phase, and the resolving, or thawing phase. The freezing phase is the most painful. Patients start to experience shoulder pain with movement or at rest, and range of motion begins to decrease. This phase can last 3-6 months. During the frozen phase, pain starts to subside but the shoulder is stuck with decreased range of motion. Pain only occurs if the patient attempts to range the shoulder beyond what the body will allow. This phase lasts 4-9 months. Finally, the thawing phase is when the body releases the inflammation and the range of motion gradually returns to normal.
Left untreated, the natural history of frozen shoulder from onset of symptoms to resolution is 2 years. With early diagnosis and treatment, we hope to avoid a lengthy course of pain and limited motion. Physical therapy is key. Gentle stretching of the capsule to maintain and improve motion is performed under the guidance of a trained physical therapist with experience in shoulders. However, if the inflammation is not reduced, physical therapy will not be as successful. Oral NSAIDs like ibuprofen or naproxen can be used. Cortisone injections into the shoulder can also provide pain relief and decrease inflammation. When used in combination, surgery can often be avoided. If symptoms fail to improve despite at least 6 months of non-operative treatment, arthroscopic surgery is offered. With the patient under general anesthesia, a camera is placed into the shoulder joint through a small incision. A second small incision is used to introduce instruments into the shoulder and the scar tissue is released. After releasing the scar tissue, the shoulder is taken through a range of motion to ensure full range of motion can be achieved and that all scar tissue has been adequately released. After surgery, physical therapy is done three times per week to maintain shoulder range of motion. If you are experiencing signs of frozen shoulder, please consult your orthopedic specialist.
Dr. Morgan cares for patients in Glendale as well as Pasadena, Burbank, La Canada, La Crescenta and surrounding areas.
Call 818-863-4446 to schedule your appointment with Dr. Morgan today!