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Shoulder pain, Stingers/Burners, Paresthesia, Frozen Shoulder

Frozen Shoulder

Frozen shoulder refers to a shoulder joint that is unable to move properly due to scar tissue. This scar tissue develops when a shoulder is unable to move through its full range of motion. Frozen shoulder typically develops from injuries such as fractures, torn bicep tendons, rotator cuff tears, or soft tissue inflammation.

Usually, frozen shoulder takes two to nine months to develop. Due to overuse of the shoulder joint, bursitis or tendonitis may develop in the rotator cuff. Bursitis is the inflammation of the bursae; which is a small fluid-filled sac that cushions the bones, tendons, and muscles near your joints. 

With a frozen shoulder, the shoulder capsule loses some of the synovial fluid that keeps the joint lubricated. The connective tissues surrounding the ball and socket joint of your shoulder, thicken and contract due to the lack of synovial fluid. With these conditions, the shoulder loses its normal capacity to stretch and move. 

Symptoms of Frozen Shoulder

  • Pain and Stiffness That Make it Difficult or Impossible to Move Your Shoulder 
  • Dull or Achy Pain in one Shoulder
  • Pain in the Shoulder Muscles That Wrap Around the top of Your arm
  • Pain That Worsens at Night and Makes it Difficult to Sleep

Stages of Frozen Shoulder

In the Freezing stage, you develop a pain in your shoulder whenever you move it. The pain worsens and interferes with sleeping patterns. You become limited in how far you can move your shoulder. This beginning phase of frozen shoulder lasts anywhere from 6-9 months.

In the Frozen stage, your pain may lessen, but your mobility decreases. Moving your shoulder becomes more difficult making it harder to perform daily activities. This stage can last 4-12 months. 

For the Thawing stage, your range of motion starts to go back to normal. This process can take anywhere from six months to two years. 

Contributing Factors

Women are more at risk for frozen shoulder than men. People between the ages of forty and sixty are more likely to develop frozen shoulder. Your risk of developing this condition may also increase if you are recovering from a stroke or a mastectomy (surgical breast removal). 

Certain medical conditions may also increase your risk for frozen shoulder. 10-20% of diabetics have suffered from frozen shoulder at one point. People with heart disease, thyroid disease or Parkinson’s disease also have an increased risk of developing a frozen shoulder. 

Treatment

Home treatment and care include icing for fifteen minutes several times a day. Most people with a frozen shoulder can improve their condition without having surgery. Over the counter drugs such as aspirin or ibuprofen can help relieve pain and inflammation. You may also receive a corticosteroid injection. Corticosteroid is a steroid that is injected into the affected area. Ideally, this injection will reduce inflammation, relieve pain, and reduce tissue swelling. 

For joint distension treatment, your doctor will inject sterile water into your shoulder capsule to increase shoulder movement. Stretching after this injection and working on increasing range of motion will help maintain movement in the joint. 

Physical therapy may or may not aggravate the shoulder depending upon the stage of your frozen shoulder.

Surgery is rarely suggested for a frozen shoulder, but in the case that surgery is needed, surgery will be administered using an arthroscopic procedure. This means that the surgery is performed with lighted, pencil-sized tools that are inserted through tiny cuts in your shoulder. 

Surgeons may forcefully move the shoulder under general anesthesia, this is referred to as shoulder manipulation. Arthroscopic surgery has mostly replaced shoulder manipulation. 

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