Shoulder

Frozen shoulder

Bark zamrozonyThe frozen shoulder syndrome (FSS) may be a frequent cause of chronic shoulder pain. It is sustained by about 5% of the population, mainly women. It is a treatable disease but the recovery is a long-term process. The disease substantially hinders everyday life.

What is FSS
FSS
is a disorder which substantially limits mobility in the shoulder joint and entails a growing pain. The primary frozen shoulder syndrome does not show any clear causes, such as sudden injury, effects of surgery which may lead to emergence of this dysfunction. Imaging examinations and histopathological studies show that the frozen shoulder is an inflammatory condition of the synovial fluid and stranding of the joint capsule. A collagen tissue which resembles a scar shows up. Vascularization and innervation of a new tissue explains why the frozen shoulder is so painful and causes stiffness.

The frozen shoulder syndrome is known to entail an extreme pain without considerable tissue damage.

The frozen shoulder is often sustained by women aged 40-60 and may be a result of immunological, biochemical and hormonal disorders. Recent studies demonstrate a high correlation between FSS and diabetes, thyroid issues, increased fat concentration in blood, and stress.

Three stages of frozen shoulder
1. Freezing stage – lasting from 1 to 8 weeks.
Initially persons experience pain when taking everyday activities. This pain is frequently perceived as a minor overload. Another symptom is limited movement. In certain cases the pain and stiffness may occur in a reversed order. The pain prevents a person from sleeping on the shoulder in question. According to latest news, the first limitation applies to external rotation.

2. Frozen stage – lasting from 9 to 16 months.
Rest pain is reduced, sometimes persons experience pain at night. However stiffness advances and patients have difficulties with simple everyday activities, such as fastening bra, reaching seatbelts in the car.

3. Defrosting stage – lasting from 12 to 40 weeks.
The joint regains mobility on its own. Nevertheless full recovery rarely occurs and pain moves to another shoulder.

Treatment

As far as frozen shoulder is concerned, it is important that we never ignore initial symptoms. Fast physiotherapeutic reaction may foster recovery. FSS is treated by a physiotherapist who focuses on trigger points, muscle grooves, fascia (e.g. FDM), deep massage, manual therapy, anti-pain exercises and exercises responsible for reducing shoulder stiffness (including breathing). Regularity and commitment in rehabilitation, based on suitable education, are a key to reduce pain and regain full capabilities. In extreme cases, when a conservative treatment turns out to be fruitless, a surgery is necessary. During the surgery a doctor cuts the synovial capsule and releases the joint. After the surgery it is necessary to be active and start intensive rehabilitation immediately.

Injury nature, causes, symptoms and methods of treatment discussed by:
mgr Michalina Kaczmarek, a Rehasport Clinic physiotherapist