Frozen Shoulder

In this three part 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 generally affects persons between 40 to 60 years of age and twice as many women as men.  Commonly afflicts 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).

Frozen shoulder often starts from an unidentifiable source and progresses over several months

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?

Adhesive capsulitis is another name for Frozen shoulder.  It is ‘a soft tissue capsular contracture accompanied by painful and restricted motion of the Gleno-humeral 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.   The shoulder is the most mobile joint in the body.  Restricting its motion causes significant disability.  The capsule literally shrink wraps the two bones together.  The space inside this joint often decreases to less than a 10th of its normal size. This produces compression between the two bones and leads to much of the pain of the syndrome.

Risk Factors:

There are several health problems that are associated with increasing likelihood of developing this condition:

Diabetes

Chronic obstructive pulmonary disease (COPD)

Asthma

Chronic Bronchitis (Emphysema)

Heart disease

Cervical disc disease

Thyroid disorders

Inflammation is a common condition which increases the risk of 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 elbow or shoulder surgery especially if joint is immobilized or splinted for a prolonged period.  Surgeries such as  Mastectomy, Breast reconstruction, or other Thoracic surgery can also increase the risk.  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 this condition 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.

There is help

Are you having trouble with your shoulder?  Contact us here if you would like to discuss your case or make an appointmenet