The best frozen shoulder treatment starts with a home exercise program
A frozen shoulder (also called adhesive capsulitis) is a condition that causes very limited motion of your shoulder and severe pain when you try to move your shoulder. No one is exactly sure what causes a frozen shoulder but certain conditions seem to make it more likely.
Frozen shoulder treatments will focus on improving your range of motion and reducing your pain.
Frozen shoulder is more likely if:
•You have diabetes, thyroid problems,
or Parkinson's Disease
•Your shoulder is immobilized
following surgery or an injury
Your shoulder is a ball and socket joint that is contained in a capsule with synovial fluid that lubricates the joint.
The shoulder joint is held in place by several muscle groups that slide over the top of each other to allow motion in all directions.
When you have a frozen shoulder the joint capsule becomes inflamed, stiff and dry making motion difficult and painful.
with arrow showing inflammation of
Shoulder Joint Capsule
Image thanks to RSatUSZ, via Wikimedia Commons
You may also develop adhesions that are like little bits of scar tissue that form between the multiple muscle layers around your shoulder. When the layers of muscle surrounding your shoulder become stuck together by these adhesions it makes motion impossible.
These frozen shoulder treatments will attempt to break these adhesions loose.
Be alert for, and do not ignore, minor problems or slight pain when stretching. If you begin to have pain doing things that you used to do there is a problem.
If you have shoulder pain reaching a high shelf, putting your hand behind your back, or brushing your hair, you may be having early signs of developing a frozen shoulder.
If you begin serious frozen shoulder treatment exercises 2 or 3 times per day while the problem is minor you can prevent more complicated problems later.
•Put your arm across the front of your body and try to touch your elbow to your opposite shoulder.
•Use your other hand to pull your upper arm in under your chin stretching your shoulder.
•Stand facing the wall and walk your fingers up the wall as far as you can.
•When your shoulder feels tight lean into the wall stretching your shoulder.
•Stand with your elbow close to your body and bent 90 degrees while grasping a door knob.
•While keeping your elbow close to your body,
rotate your body away from your hand stretching your shoulder.
Prevent a Frozen Shoulder
These 3 exercises, if started early and performed consistently 2 or 3 times per day, will help prevent a frozen shoulder. It is important to start these when your symptoms are mild.
If your symptoms are becoming more severe or prevent normal activity you will need to see your doctor for considering more aggressive frozen shoulder treatment such as steroid injections or surgery.
If your symptoms are getting worse your doctor may elect to send you to a physical therapist for a supervised aggressive stretching program.
There is No Magic
Many times having someone help you with the exercises can make them more effective. They can make small changes in your positioning and encourage you to work a little harder.
However, there is no magic at the physical therapy place. It is you doing the work 2-3 times per day that will make the difference and help you improve.
If There is No Improvement
If after 6 weeks of aggressive stretching your range of motion is not improving your doctor may refer you to a specialist to consider steroid injections.
Injections of steroid medication into the inflamed the area will decrease the swelling and inflammation allowing better motion. You will need to continue your aggressive stretching program for several more weeks while the steroid medicine is still working.
In severe cases where the problem has been present for several months you may have developed adhesions or bits of scar tissue between the many layers of muscle that surround your shoulder.
Scar tissue between the layers will prevent them sliding over the top of each other and a severely restrict your shoulder range of motion.
Before considering surgery your surgeon may order an MRI for a more complete evaluation. This study will show scar tissue, inflammation, and any other problems that may exist with your shoulder.
If your MRI does not show large amounts of scar tissue your surgeon may elect to perform a manipulation of your shoulder. In this procedure, the doctor will put you to sleep with anesthesia and then move your shoulder through its full range of motion.
Breaking Up Scar Tissue
Forcing your shoulder through its full range of motion will break loose any adhesions and stretch the muscles and ligaments that hold your shoulder in place. You will then get started back with physical therapy exercises to prevent the scar tissue returning.
If your surgeon thinks there is more scar tissue than he can safely break loose with a manipulation you may need to consider surgery.
Using a camera and very specialized instruments the surgeon can make two or three small incisions that allow him to remove the scar tissue and separate the layers of muscle. Again, you will need to get started right away with your physical therapy exercises to prevent the scar tissue from re-forming.
If your shoulder range of motion is becoming more and more limited you need to get started with the frozen shoulder treatment stretching exercises to begin improving your range of motion.
If after doing the exercises two or three times per day for a few weeks you are not improving, or if your symptoms are getting worse, you need to make an appointment with your doctor for further evaluation.