A frozen shoulder is a common term used to describe an adhesive (inflamed and thickened) capsule of the shoulder joint, which causes pain and reduced range of motion of the shoulder joint. To understand a frozen shoulder, make a fist, place your opposite hand over your fist and grasp your fingers tightly over your fist. Now try to rotate your fist. This is what happens in a frozen shoulder namely, the capsule tightens around the head of the humerus (arm bone), restricting shoulder movement. The restriction of motion in a frozen shoulder may vary from mild, moderate, to being severely limited. The pain may be felt along the upper outside aspect of the humerus, around the shoulder joint or at the back of the arm. Patients with this injury have difficulty with lifting their arm upwards, sideways or tucking their shirt in.
The cause of a frozen shoulder has been classified in two forms. In the primary form, there is no underlying cause that can be identified i.e. it just occurs. The secondary form has been associated with an injury(a fall or fracture), post-surgery or after a limited period of pain & immobilization due to a rotator cuff tear, bursitis or tendonitis. There are many causes of shoulder pain therefore making the correct diagnosis is most important in achieving a positive outcome.
The treatment and management of a frozen shoulder can include the following:
- Modalities to reduce pain i.e. ultrasound, laser and interferential
- Acupuncture has proven to be successful in the treatment of shoulder pain
- Manual therapy is used to assist with loosening the muscles surrounding the shoulder and mobilizing the joint to improve the range of motion
- Extracorporeal Shockwave Therapy can be used to treat chronic trigger points of the neck, shoulder and upper back by breaking down adhesions and thickened tendons while stimulating the joint to heal
- Core stability of the postural & range of motion exercises have a positive effect in improving shoulder strength and mobility
- Postural education with respect to correct, sleeping position, work ergonomics and modifications to your activities of daily life
A customized exercise program plays an important role in managing the pain, increasing shoulder mobility/strength and restoring function.
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