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3 stages of Frozen Shoulder (Adhesive Capsulosis)

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Last Updated on August 19, 2024

Imagine waking up one morning and reaching for your alarm clock, only to find that your shoulder won’t budge without a sharp, intense pain shooting through it. Tasks you once performed effortlessly—brushing your hair, putting on a jacket, reaching for an item on a high shelf—suddenly become excruciatingly difficult. This is the reality for individuals suffering from frozen shoulder, a condition marked by pain, stiffness, and a significantly limited range of motion in the shoulder joint. Frozen shoulder can develop gradually and persist for months or even years, severely impacting one’s daily life. This post will help us Understand the symptoms, causes, and stages of this debilitating condition is crucial for effective treatment and a smoother path to recovery. 

What is a Frozen Shoulder? 

The symptoms of frozen shoulder, sometimes referred to as adhesive capsulitis, include pain and stiffness in the shoulder joint. It has to do with the connective tissue that surrounds the shoulder joint, the shoulder capsule, getting thicker and tighter. Because of this condition’s restriction on shoulder movement, performing daily tasks can be painful and difficult. Usually, frozen shoulder develops in three stages, each with unique symptoms and difficulties. 

What Causes a Frozen Shoulder? 

The exact cause of frozen shoulder is not always clear, but several factors can increase the risk of developing this condition. One common cause is prolonged immobility or reduced shoulder movement, often due to injury, surgery, or other shoulder conditions. Medical conditions such as diabetes, thyroid disorders, cardiovascular disease, and Parkinson’s disease are also associated with a higher risk of frozen shoulder. Additionally, individuals over the age of 40 and women are more prone to developing this condition. 

What Are the Symptoms of a Frozen Shoulder? 

Frozen shoulder presents several symptoms that can vary in intensity and duration. The most common symptoms include persistent shoulder pain, which is often exacerbated by movement and becomes particularly intense at night. Another key symptom is a reduced range of motion, making activities such as reaching overhead, behind the back, or to the side challenging and painful. Additionally, the shoulder feels tight and stiff, further restricting movement. 

Muscle weakness is also a common symptom due to disuse and pain, causing the shoulder muscles to weaken over time. These symptoms typically progress through three stages, each with its own characteristics and challenges. Early recognition and intervention are crucial for effective management and to prevent further deterioration of the shoulder joint. 

3 Stages of Frozen Shoulder (Adhesive Capsulitis) 

Frozen shoulder progresses through three distinct stages: the freezing stage, the frozen stage, and the thawing stage. Each stage presents unique symptoms and requires specific management strategies to mitigate discomfort and promote recovery. 

Shoulder Pain

Stage 1: ‘Freezing’ 

The freezing stage is the initial phase of frozen shoulder and can last anywhere from six weeks to nine months. During this stage, the primary symptom is pain, which gradually worsens over time. As the pain increases, the range of motion in the shoulder begins to decrease. This stage is often the most painful and can significantly impact daily activities, making it difficult to perform tasks that require lifting or rotating the arm. In addition to physical limitations, the constant pain can also affect sleep and overall quality of life, leading to frustration and fatigue. 

Stage 2: ‘Frozen’ 

The frozen stage, also known as the adhesive stage, typically lasts between four to six months. During this phase, the pain may begin to diminish, but the shoulder remains stiff. The range of motion is severely restricted, making it difficult to perform everyday tasks that involve shoulder movement. Although the pain is less intense than in the freezing stage, the stiffness can be quite debilitating. This stage can be particularly challenging for individuals as they struggle with a significant loss of shoulder function, impacting their ability to dress, groom, and engage in recreational activities. 

Stage 3: ‘Thawing’ 

The thawing stage is the final phase of frozen shoulder and can last from six months to two years. During this stage, the shoulder’s range of motion gradually improves, and the pain continues to decrease. The stiffness slowly resolves, and shoulder function starts to return to normal. Full recovery may take a considerable amount of time, but most patients eventually regain their shoulder mobility. This stage requires patience and consistent adherence to physical therapy exercises to ensure the restoration of shoulder strength and flexibility. The gradual improvement in mobility and reduction in pain provide a sense of relief and hope for those recovering from this debilitating condition. 

Diagnosis 

Early diagnosis of frozen shoulder is crucial for effective treatment and management. Healthcare professionals use a combination of medical history, physical examination, and imaging tests to diagnose frozen shoulder. 

Recognising the symptoms of frozen shoulder early can prevent further deterioration and complications. Early diagnosis allows for timely intervention with non-surgical treatments, physical therapy, and exercises, which can significantly improve outcomes. It is essential to consult a healthcare professional if you experience persistent shoulder pain and stiffness. 

Non-Surgical Treatments for Frozen Shoulder 

Several non-surgical treatments can help manage the symptoms of frozen shoulder and improve shoulder function. These treatments aim to reduce pain, increase the range of motion, and restore shoulder mobility. 

Nerve Block Injections 

Pain Doctors use nerve block injections to alleviate pain and help reduce inflammation in chronic shoulder conditions. This approach is safe, effective, and often combined with other treatment methods to enhance overall results. Managing pain is crucial in the early stages of frozen shoulder. Once the pain is under control, patients can more easily move their shoulder, preventing the onset of stiffness or contracture. 

Coreflex Injections 

Painkillers, including strong anti-inflammatory agents, often fall short in treating frozen shoulder due to their limited effectiveness against stiffness and muscle spasms. To address these issues, Coreflex injections can be used to relieve frozen shoulder symptoms. Coreflex injections consist of a combination of anti-inflammatory agents, anesthetics, and muscle relaxants. These injections are administered to the muscles and ligaments surrounding the shoulder joint to reduce inflammation.  

Platelet Rich Plasma (PRP) 

Platelet-Rich Plasma (PRP) injections offer significant benefits for treating frozen shoulder, such as reducing pain, enhancing healing, and improving shoulder function by harnessing the body’s own platelets to stimulate tissue repair and reduce inflammation. The process involves drawing a small amount of the patient’s blood, which is then centrifuged to concentrate the platelets into a rich plasma. This PRP is injected directly into the shoulder joint or surrounding tissues, targeting areas of inflammation and fibrosis to promote recovery and restore normal shoulder movement over time. 

Joint Manipulation Under Anesthesia 

When other non-surgical treatments have not produced enough relief, joint manipulation is usually taken into consideration. During joint manipulation under anesthesia, the patient is sedated while the physician manipulates the shoulder to release adhesions and increase range of motion. This process can instantly increase range of motion and decrease stiffness.  

Preventing Frozen Shoulder 

Shoulder stretch

While it is not always possible to prevent frozen shoulder, certain measures can reduce the risk and promote shoulder health. 

Physical Therapy 

Engaging in regular physical therapy can help maintain shoulder flexibility and strength. Physical therapists can design specific exercise programs tailored to individual needs, focusing on improving the range of motion and preventing stiffness. Early intervention with physical therapy can also aid in the recovery process and prevent the progression of frozen shoulder. 

Exercise 

Regular exercise is essential for maintaining shoulder health and preventing frozen shoulder. Incorporating stretching and strengthening exercises into your routine can improve flexibility and reduce the risk of developing shoulder stiffness. It is important to perform exercises correctly and consistently to achieve the best results. For more information on specific exercises for frozen shoulder, refer to our article on frozen shoulder exercises. 

Conclusion 

Frozen shoulder is a condition characterised by pain and stiffness in the shoulder joint, progressing through three distinct stages. Early diagnosis and timely intervention with non-surgical treatments, physical therapy, and exercises can significantly improve outcomes and restore shoulder function. While it may not always be possible to prevent frozen shoulder, maintaining shoulder health through regular exercise and physical therapy can reduce the risk and promote recovery. If you experience persistent shoulder pain and stiffness, it is essential to consult a healthcare professional for proper diagnosis and treatment. 

 

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