FROZEN SHOULDER

(Syn. Periarthritis Shoulder, Adhesive Capsulitis)

Frozen Shoulder Syndrome usually presents as a limitation of shoulder movements associated with pain. It usually presents around the age of 40 years equally affecting males and females. Diabetic and obese people are more prone to it. Bilateral frozen Shoulder is almost always found in Diabetics. It usually starts with minor trauma, often ignored by the patient. The patient often claims it to have insidious, spontaneous onset.

On many occasions the patient may have been confined to bed rest for some medical problem, does not do any shoulder movements, and hence gradually slips into shoulder stiffness. Cervical Spondylosis when causes pain in neck and around shoulder, may initiate and precipitate frozen shoulder.

Treatment is simple.

Diabetes must be ruled out in all the patients and treated well in those who are suffering from it.

No treatment will ever succeed unless diabetes is controlled.

X-ray should be done to rule out other associated disorders

 E.g. Koch’s, metastatic deposits

Patient needs anti inflammatory drugs (NSAIDS) to control the inflammatory process going on inside.

Muscle relaxants are needed to relieve the spasm of the muscles. They facilitate the shoulder movements.

Neurotropics, antioxidants and omega three fatty acids are needed to improve the general metabolism and health of the patient. They also potentiate the analgesic effect of NASAIDS.

Sometimes manipulation of the shoulder under General Anaesthesia may have to be undertaken.

With advancement of surgical technology, arthroscopic fibrinolysis of the shoulder joint is undertaken with good results.

In the end, it is the active physiotherapy that is the sheet anchor of treatment, until the patient makes a wilful determined effort no treatment will succeed.