Frozen shoulder is pain and stiffness in the shoulder area that makes it difficult for the sufferer to move the shoulder joint or upper arm. These complaints can last for several months, even years .
The shoulder joint has a protective capsule of interconnected connective tissue. The capsule protects the bones, ligaments and tendons that make up the shoulder joint. Frozen shoulder occurs when scar tissue thickens the protective capsule, limiting movement in the shoulder joint.
Frozen shoulder is also known as adhesive capsulitis . This condition generally appears and worsens slowly, then gradually improves on its own. However, the time it takes to heal is different for each person.
Frozen Shoulder Causes and Risk Factors
It's not known what causes frozen shoulder . However, there are several factors that can increase a person's risk of developing this condition, namely:
- Female gender
- Age 40 and over
- Have a systemic disease, such as diabetes , Parkinson's disease, tuberculosis, heart disease, or a thyroid hormone disorder ( hyperthyroid or hypothyroid )
- Experiencing immobility (unable to move) for a long time, for example due to stroke, broken arm, recovery after surgery, or injury to the rotator cuff (muscle around the shoulder)
Frozen Shoulder Symptoms
Frozen shoulder can greatly interfere with the activities of sufferers. The following are some examples of movements that are difficult for people with frozen shoulder to do :
- Putting on clothes
- Comb the hair
- Back scratching
- Putting on a bra
- Reaching for items on high ground
Frozen shoulder symptoms generally develop slowly in three stages, each of which can last several months. The three stages are:
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The first stage or freezing stage
. This stage is characterized by pain every time the shoulder joint is moved, thereby limiting its movement. This period lasts 6–9 months. -
The second stage or frozen stage
The second stage is characterized by starting to reduce pain, but the shoulder joint becomes increasingly stiff and difficult to move. This period can last from 4 months to 1 year. -
The third stage or thawing stage
The third stage is characterized by shoulder movements that are starting to improve. This stage generally lasts 6 months to 2 years.
In some people with frozen shoulder , pain in the shoulder joint can be worse at night and even disturb sleep.
When to see a doctor
Even though it can subside by itself, frozen shoulder can reduce the quality of life of sufferers because it interferes with movement and activity. Therefore, sufferers are advised to see a doctor, so that doctors can provide treatment to relieve symptoms and speed up recovery.
Frozen shoulder diagnosis
The doctor will ask the patient about the symptoms experienced and the history of the disease they have. Next, the doctor will perform a physical examination of the patient's shoulder and arm in the following two ways:
- Ask the patient to move the arm and shoulder, to find out the range of the patient's arm in active movement
- Ask the patient to relax the shoulder muscles and direct the patient's arm to a certain movement, to determine the reach of the patient's arm in passive movements
Doctors can generally determine frozen shoulder through the physical examination above. However, if necessary, the doctor will carry out supporting examinations, such as X-rays or MRI , to rule out the possibility that the patient's complaints are caused by other conditions, such as arthritis (arthritis).
Frozen Shoulder Treatment
There are several treatment methods that can be given by doctors to deal with complaints due to frozen shoulder , namely:
Drugs
Medicines given by doctors aim to relieve pain and inflammation. Examples of drugs are aspirin, ibuprofen , and naproxen sodium. If the pain persists, your doctor may give you a corticosteroid injection into the affected shoulder area.
Physiotherapy
Physical therapy ( physiotherapy ) aims to restore the reach of the arm as much as possible. In physiotherapy for frozen shoulder , the patient will be taught movements that can help the recovery process. It is important to remember, treatment with this method requires patient commitment so that the results of therapy are maximized.
During physiotherapy sessions, doctors may also perform TENS ( transcutaneous electrical nerve stimulation ). TENS is an electrical therapy that is done by sending a small electric current through electrodes that are attached to the skin. The electric current aims to block the nerve impulses that cause pain.
In addition to the above therapy, patients can also independently apply cold compresses on the shoulder for 15 minutes, several times a day. It is considered quite effective to relieve pain in the shoulder.
If physical therapy and medications don't help, your doctor may perform several other procedure options, such as:
-
Shoulder joint manipulation Shoulder manipulation is performed by giving general anesthesia first, so that the patient falls asleep and does not feel pain during the manipulation. After the patient is under anaesthesia, the doctor will move the patient's shoulder in various directions to relax the tense joint capsule tissue.
-
Shoulder
distension Shoulder distension is the procedure of injecting sterile water into the joint capsule. This procedure aims to stretch the capsule tissue of the shoulder joint and make it easier to move the joint. -
Arthroscopy
Arthroscopy is performed by inserting a small camera device (arthroscope) through an incision around the joint. Arthroscopy aims to remove scar tissue and adhering tissue in the shoulder joint.
Frozen Shoulder Complications
Complications that may arise from frozen shoulder are stiffness and pain in the shoulder that lasts a long time. In some cases, patients can experience stiffness or shoulder pain for up to 3 years despite receiving medication.
Complications can also occur from manipulation of the shoulder, such as a fracture of the upper arm (humerus) or a tear in the upper arm muscle.
Frozen Shoulder Prevention
For patients who are in the process of recovering from injury or surgery, it is recommended to always move the arm to avoid frozen shoulder . If it is difficult to move the shoulder, discuss with your doctor about the types of movements that can be used to maintain range of motion of the shoulder.
In addition, stroke patients are also advised to immediately run physiotherapy after a stroke . This is to prevent stiffness in the shoulder joint and other affected joints.