What is Frozen Shoulder?
Frozen shoulder is a seriously debilitating condition that can significantly affect your daily functioning and cause a lot of pain and discomfort. It is characterized by a loss of shoulder mobility in nearly every direction of movement as if the shoulder has literally frozen in place. Any attempts to move it can be incredibly painful. Not only can you not move your arm, but also your doctor cannot move your arm without inflicting pain. In technical terms, there are restrictions in both active range of motion (you creating the movement yourself) and passive range of motion (the doctor creating the movement for you). External rotation movements, (such as raising your hand to wave or washing your hair) are usually the worst.
Also known as adhesive capsulitis, frozen shoulder occurs when the shoulder capsule (the connective tissue surrounding the joint) becomes inflamed, thickened and potentially even scarred. Pain can be excruciating, and it usually gets worse at night, particularly when lying on the affected side and/or with cold weather.
Causes of Frozen Shoulder
No one really knows why some people get frozen shoulder. It is believed to be closely related to trauma, immobility, and may also have an autoimmune component. There are also some patients who are at more of a risk of developing the condition. Specifically, it is more common in women than men, particularly between the ages of 40-70 years old.
Those suffering from diabetes, rheumatoid arthritis, shoulder osteoarthritis and those who have had a history of trauma to the region are also much more likely to present with frozen shoulder. Not only are they more likely to present with frozen shoulder, but they also usually present with more severe forms of frozen shoulder as well. When pain is chronic, it can lead to changes in nerve tissues so that pain may persist even after the stimulus is removed or the damage is repaired. In general, maintaining movement is considered to be the best prevention strategy for frozen shoulder. It may seem counter-intuitive to want to move it when it is painful, however this movement will prevent the development of adhesions that lead to the loss of motion within the joint.
The Stages of Frozen Shoulder
Frozen shoulder is often broken up into 3 stages. Stage 1, or the “freezing” stage. This is the stage associated with the slow onset of pain in which the shoulder begins to lose its range of motion. This stage usually lasts 6 weeks, but up to 9 months.
Stage 2, or the “frozen” phase, is the stage where the patient presents with classic frozen shoulder, e.g., they struggle to move their arm at all. This stage alone can last up to 9 months. This may impact on both the patient’s physical and mental health. Many patients suffer from depression during this stage due to an inability to function as they used to. For physical professions, such as manual laborers, frozen shoulder can greatly impact on their ability to work, leading to economic stress on top of everything else. Stage 3, or the “thawing” phase, is the recovery phase. It will usually last between 6 months to one or two years. Frozen shoulder should be treated very aggressively, due to the severity of the pain and the long-term health effects of immobility both physically and psychologically. Without treatment, frozen shoulder may be permanent.
Frozen Shoulder Treatment
The typical treatments prescribed by practitioners consist of a combination of anti-inflammatory medication, cortisone injections and manual therapy. In some patients, the combination of these treatments may not be enough, and they may require manipulation under anesthesia to break down the scar tissue. While I do perform these procedures under anesthesia, my preference is to go without whenever possible. In general, I believe it is more important to focus on any imbalances in muscle function and slight joint movements, and correct them slightly to allow normal function of the shoulder to return more quickly. This is done without the need for anesthesia.
Generally, the prognosis is fairly good. Most patients do not require manipulation under anesthesia and are able to regain all of their shoulder range of motion. In addition to Dr. Steven Becker’s approach, some modalities often used include: ultrasound, electric stimulation, stretching, icing, mobility exercises, and eventually muscle strengthening and reconditioning. Full recovery can take weeks to months, depending on the degree of scar tissue in the area.
Patients also have to be very careful of not injuring the shoulder further during recovery. They should avoid heavy lifting and sudden, jerky movements that may exacerbate their injuries.
Getting Chiropractic Help
Frozen shoulder can be a very uncomfortable condition. However, with proper treatment, normal shoulder movement can be restored. If you are suffering from shoulder pain, am struggling to move your arm, or just want to know more about how to strengthen your shoulder muscles, contact our office at (310) 277-8822 to schedule an appointment with Dr. Steven Becker. We are located on the corner of Beverly Drive and Pico Blvd. Dr. Steven Becker is affiliated with Cedars–Sinai Medical Center and has sub–specialties in Chiropractic Neurology and Orthopedics. Dr. Steven Becker lives and works in Los Angeles and frequently sees patients from the surrounding neighborhoods in West Los Angeles (West LA) including Century City, Beverly Hills and Culver City. He specializes in treating shoulder pain as well as neck pain, headaches, sciatica, neuropathy, coccydynia and spinal stenosis, to name a few. Please feel free to call with any questions or comments.