In this series of posts I will examine a painful and frustrating condition called Frozen shoulder. Frozen Shoulder (AKA Adhesive Capsulitis) is a common condition treated by Chiropractors, and other manual therapists. It affects persons between 40 to 60 years of age and twice as many women as men.
It is more common in the non-dominate arm and can occur in both arms at the same time. It can be frustrating for patients because it can be hard to recognize at first and traditional approaches (such as pain medication) offer little relief. Frozen Shoulder typically starts slowly and from no identifiable cause (although less commonly it can start as a byproduct of another condition – such as post-surgery recovery or after a heart attack).
Most shoulder conditions start from a defined injury – such as a fall or other trauma and tend to improve with time. Frozen shoulder is the opposite – begins generally with no identifiable cause and it gets progressively more painful and restricted (see graph below). It is this difference that frustrates patients and Doctors alike.
What exactly is Frozen shoulder?
It has been defined as ‘a soft tissue capsular contracture accompanied by painful and restricted motion of the Glenohumeral joint (shoulder joint)’. The capsule is a ligament that attaches the arm bone to the shoulder blade and encloses the joint space between the bones.
A restricted shoulder capsule is a significant disability because of the normally large range of motion. The capsule literally tightens down or shrinks, in fact the volume inside this joint often decreases to less than a 10th of its normal size. This is significant as it produces compression between the two bones and leads to much of the pain of the syndrome.
There are several health problems that are associated with increasing likelihood of developing Frozen shoulder:
DiabetesChronic obstructive pulmonary disease (COPD, Asthma, Chronic Bronchitis, Emphysema)Heart diseaseCervical disc diseaseThyroid disorders
A common thread among all of these is inflammation which is thought to play a role in triggering the contracture (shrinking or tightening) of the capsule.
There can be secondary causes after injury or when another pre-existing painful condition exists in another area.
Common Causes of secondary Frozen shoulder:
Fractures of the wrist or elbowShoulder surgery especially if joint is immobilized or splinted for a prolonged periodMastectomyBreast reconstructionHeart Attack
We successfully treat Frozen shoulder with a multifaceted approach incorporating Diet, Rest, Exercise, Alignment and Mindfulness. In the next few posts I will explain how Frozen shoulder progresses and how it can be treated without drugs or surgery.
In the meantime I hope this has provided some understanding. Understanding is key for a patient to be able to help themselves with this condition. If you have some of these risk factors do what you can to minimize them. If you have any immediate questions about Frozen shoulder, please contact my office.