Frozen shoulder (adhesive capsulitis) is a condition in which the main problems are pain and stiffness in the shoulder. It occurs in about 2% of the population, is much more common in women than in men, and most often affects the population between 40 and 60 years of age.
In this condition, the joint capsule in the shoulder becomes very irritated and thickened. The surrounding tissue also becomes firm and inelastic. Very often, there is an increased amount of joint fluid in the joint itself. As a result, there is an inability to move the shoulders, either of their own free will or with someone’s help. The process itself takes place in 3 stages:
- Freezing phase. At this stage, pain occurs and movements are more and more restricted. This phase can last from 6 weeks to as long as 9 months, the usual duration is 4 – 6 months. The pain can be extremely severe and constant, so patients can be severely handicapped for daily activities.
- Frozen shoulder. At this stage, the pain is usually minor or non-existent, but the restriction of movement is still present. Daily activities at this stage of the disease can be a big problem, and it usually lasts 6-12 months.
- Defrosting phase. Gradually, there is an improvement in the mobility of the shoulders, and as a rule, there is no pain. This phase, i.e. Recovery can take from 6 months to 2 years. In complex cases, it happens that the pain is present all the time, and it can happen that, when the process is completed on one shoulder, it starts on the other.
The causes that lead to the appearance of scabies shoulder cannot be fully explained. There is no connection between a frozen shoulder and a dominant hand or the type of work a person does. However, there are several factors that can affect the occurrence of this condition. These are diabetes, thyroid disorders, Parkinson’s disease. A woman with diabetes has a 25% chance of getting a frozen shoulder at least once in her life. Frozen shoulder can also occur during shoulder immobilization (fractures, surgeries) and therefore it is important to start with early shoulder movements in these cases.
Pain is the dominant symptom. It exists in a state of rest, is often constant and intensifies considerably when moving. It is located on the outside of the shoulder, but often spreads down the arms. Another symptom is limited mobility, both active and passive. In particular, the external rotation of the shoulder is reduced, because the process is predominantly in the anterior capsule of the shoulder.
In the first phase, the treatment is exclusively non-operative and consists of physical procedures and shoulder blockages. The goal of treatment at this stage is to reduce pain, and no significant improvement in mobility is usually expected. Therefore, at this stage, you should not insist on exercises, and the movements should be performed to the limit of pain.
Operative treatment is carried out in the second stage by arthroscopic loosening of the joint capsule. The operation itself is minimal and very grateful, because the patient immediately gets the maximum possible mobility. That is why it is important to start exercising immediately after the operation, which should be carried out by an experienced physiotherapist, because it is very important to preserve the mobility obtained by the operation. Without intensive kinesitherapy, the shoulder joint tends to stiffen again very quickly.
