Other Pain Relief Measures
If conservative treatment, including physical therapy and nonsteroidal anti-inflammatory drugs , isnt relieving enough to relieve your frozen shoulder pain, there are other alternative possibilities to discuss with your doctor:
- Anecdotally, some people find relief in acupuncture, though there are few randomized studies on the effectiveness of this therapy for frozen shoulder.
- Another potential therapy is TENS, or transcutaneous electrical nerve stimulation, though studies havent confirmed its effectiveness.
- A for frozen shoulder found no added advantage to standard treatment after one month.
Which Is Better For Treating Frozen Shoulder: Ice Or Heat
People get confused with how ice and heat work to relieve pain and heal. They also get confused with which temperature treatment is better for their injury and how to get the right amount of “ice” or “heat” for effective treatment.
When it comes to using ice and heat for treating a frozen shoulder injury, it’s important to keep in mind that both ice AND heat are very effective ways to relieve pain and heal. Most people will think one is better over the other from their own experience or what a doctor / physical therapist has previously told them.
The only difference between using ice and heat is that 1 is better for you at a specific time in your healing cycle and whether your frozen shoulder injury is at the ‘freezing’, ‘frozen’ or ‘thawing’ stage. Ice is used first, right when you get your injury , to decrease pain / swelling and inflammation. Ice is also essential when your frozen shoulder starts to heal in the ‘thawing stage’, as your pain spikes while you regain movement of your shoulder.
Heat comes later, to increase blood flow circulation and stimulate the body’s healing response. Heat is also the best treatment when you’re experiencing extreme limitation of movement in your shoulder – during the ‘frozen’ stage of your injury. Heat relaxes the scar tissue surrounding your shoulder joint capsule, making it more pliable and flexible while speeding up the natural healing response that will eventuall ‘thaw’ out your injury.
So which is better?
What Is A Frozen Shoulder
A frozen shoulder, also called adhesive capsulitis, is a condition where your shoulder movement is limited. Often, this restriction in movement occurs through three phases.
The first stage, the freezing stage, is when the shoulder first becomes painful and stiff. Frequently, this happens from an injury, whether it is minor or not. As time goes on, your ability to move your shoulder becomes less and less. The pain may also become worse at night or when you lie on your affected shoulder. This may happen gradually over many months or over only about six weeks.
The second stage, the frozen stage, is when your shoulder remains stiff. Sometimes, the pain lessens. However, you are unable to move your shoulder. This ends up limiting your ability to perform tasks throughout your day, such as reaching for items on a high shelf. Usually, this phase lasts two to six months.
The third stage is your recovery phase. Its called the thawing stage and it involves the recovery from the frozen stage. Typically, recovery takes anywhere from six months to two years. During this time, you may need to work with a healthcare professional, as well as perform specific exercises, to return your shoulder to normal function and strength.
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What Causes Frozen Shoulder
Although many shoulder diseases involve pain and loss of motion, frozen shoulder is most often caused by inflammation of the tissues surrounding the joint. The tissue that envelops the joint and holds it together is called the capsule. Normally the capsule has folds that can expand and contract as the arm moves into various positions. In a frozen shoulder, the capsule has become inflamed and scarring develops. The scar formations are called adhesions. As the capsule’s folds become scarred and tightened, shoulder movement becomes restricted and moving the joint becomes painful. This condition is called adhesive capsulitis .
It is not known exactly what causes this condition. Immobilization of the shoulder can lead to frozen shoulder. Inflammation of the muscles and/or tendons, as with rotator cuff tendinitis or bursitis, can also cause the shoulder joint to become frozen.
Treatment Goals For A Frozen Shoulder
Frozen shoulder, technically called adhesive capsulitis, is a common condition that causes stiffness, pain, and discomfort in your shoulder joint. It occurs when the range of motion of your shoulder joint is reduced to the point that it feels as though your shoulder is frozen.
Frozen shoulder usually affects people between the ages of 40 and 70. Its caused by inflammation, repetitive motions, or extended periods of disuse. Lack of mobility when youre healing from a medical condition, procedure, or injury can also be a cause. At times the cause is unknown.
Initially, the symptoms of this syndrome are minor but progressively get worse. Due to the discomfort and loss of range of motion, people who have frozen shoulder tend to use their shoulder less, which further reduces mobility.
Not using your shoulder can exacerbate your symptoms, so its important to keep your shoulder mobile. Massages and stretches can increase your range of motion and alleviate pain.
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How To Relieve Shoulder Pain: 10 Remedies To Try Yourself
The shoulder is perhaps the most flexible and the most overworked ball-and-socket joint of the entire human body. It is composed of three bones, namely, the humerus or upper arm bone, the scapula or shoulder blade, and the clavicle or collarbone.
The head of the humerus is shaped like a ball, which fits into a shallow round socket in your shoulder blade called glenoid. This relatively small ball-and-socket joint called the glenohumeral is encapsulated by a covering of muscles called rotator cuff and is secured in its place by strong cords called tendons.
Moreover, a layer of cartilage forms a cushion between the bones to keep them from rubbing together and to absorb any shock impact. Within this cocoon of cartilage, muscles, and tendons, a soft tissue called synovium secretes fluid to keep the joints lubricated and the cartilage healthy.
This intricate framework of muscles and ligaments accords a wide range of motion to your shoulder, making it the most mobile joint in your body. But with this increased mobility comes its fair share of hassles. A glitch in the working of any of the element of this complex shoulder architecture can trigger mild to chronic discomfort and pain.
Shoulder pain can spring from any of the muscles, ligaments, or tendons in and around your shoulder and can be awfully debilitating. First of all, an impairment in the shoulder greatly hampers your ability to move freely.
Frozen Shoulder Treatment In Cape Town
Pain is treated with nonsteroidal anti-inflammatory medications and steroid injections. Steroid injections and physical therapy can improve your motion. It can take a few weeks to see progress. It may take as long as 6 to 9 months for complete recovery. Physical therapy is intense and needs to be done every day. Left untreated, the condition often gets better by itself within 2 years with little loss of motion.
Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated. Surgery is recommended if nonsurgical treatment is not effective. This procedure is done under anaesthesia. During surgery, the scar tissue is released by bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, you may receive pain blocks so you can do physical therapy.
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Exercises For Frozen Shoulder
Regular, gentle exercise and stretching may relieve frozen shoulder symptoms and help you recover. Your physiotherapist will show you various exercises you can do at home and you should always follow their advice.
There are other things you can do to reduce the strain on a frozen shoulder. For example, when you raise your arm or lift objects, keep your elbow bent and in front of your body, with your palm facing up. When you lower your arm, bend your elbow and bring your hand closer to your body.
The Four Stages Of Frozen Shoulder
Typically, these particular symptoms will appear in four stages over about 24 months:
- Stage 1, months 1-3: Shoulder pain, often worse at night, which causes you to limit your arm movement.
- Stage 2, months 4-9: The freezing stage of progressive stiffness, where pain continues but you experience decreased ability to move your shoulder properly.
- Stage 3, months 10-14: The frozen stage, where the shoulder is stiff but no longer hurts when you are not moving it.
- Stage 4, months 15-24: The thawing stage, where your ability to move your shoulder gradually returns.
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How Can A Physical Therapist Help
Your physical therapist’s overall goal is to restore your movement, so you can perform your daily activities. Once the evaluation process has identified the stage of your condition, your physical therapist will create an individualized exercise program tailored to your specific needs. Exercise has been found to be most effective for those who are in stage 2 or higher. Your treatment may include:
Strengthening And Stretching Exercises
As you move into the second phase of frozen shoulder with less pain, you can increase the stretch times and the repetitions, and add in some strengthening activities.
Try adding a small weight to your affected arm in exercise 4, such as a soup can. Or, push your affected arm farther up your back in exercise 1.
Adduction means moving your arm toward your body. Its the opposite of abduction.
Youll use passive range of motion again, where you or another person gently pull on your affected arm to stretch it.
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Frozen Shoulder Treatment Options For Effective Relief
keywords: frozen shoulder stretching exercises, relief from frozen shoulder
Frozen shoulder is a medical condition that causes the shoulder joint to get stiff. It usually occurs when you sleep on your arm. The symptoms of frozen shoulder are stiffness, pain, and limited movement in the shoulder joint. See a medical professional for clarity, in Cape Town Dr CL Steyn is the top shoulder specialist…
The most common treatment option for frozen shoulder is surgery. There are other options like physical therapy, which may help relieve symptoms over time.
Physical therapy to help with relief from frozen shoulders can include exercises like stretching or muscle massage. These exercises will help with the pain and stiffness of the shoulders but won’t be able to provide relief overnight like surgery can provide.
Surgery for frozen shoulder is typically offered during “Stage 2: Frozen.” The goal of surgery is to stretch and release the stiffened joint capsule. The most common methods include manipulation under anesthesia and shoulder arthroscopy. Manipulation under anesthesia
Work On Scapular Mobility
Your shoulder is a complex joint consisting of your shoulder blade, collarbone, and glenohumeral joint. If you have a frozen shoulder, you may notice that you excessively move your shoulder blade, or scapula, when you try to lift your arm up or out to the side.
One important component of frozen shoulder rehabilitation is normalizing motion in your scapula. To do this, you can start scapular stabilization exercises. These exercises are designed to strengthen the muscles that support your scapula and improve the way that your shoulder blade, and entire shoulder joint, moves.
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Various Stages Of Frozen Shoulder
In most cases, the individuals develop the frozen shoulder in stages. Mainly there are 3 stages which are as under:
- Freezing stage in freezing stage, you generally experience a pain in your shoulder when you move it. Slowly the pain increases mostly during the night. Your shoulder movements become very restricted in freezing stage. This stage can last for up to 6 or 9 months.
- Frozen stage Here, there may be improvement as far as the pain in the shoulder is concerned but if you consider the stiffness factor then it actually worsens. You will find it too hard to move the shoulder and hence there will be lot of problems doing your daily activities. Frozen stage may last for 4 to 12 months.
- Thawing stage This is when you slowly recover. You will be able to move your shoulders better than before but the full recovery process may take a span of 6 months to as long as 2 years in some cases.
The number of frozen shoulder cases is increasing on a steady pace with the American Academy of Orthopedic Surgeons estimating around 2 to 5% of the adult population suffering from this health concern at any given time. So what are the main causes of frozen shoulder?
Prevention Of Shoulder Pain
- If you have previously suffered from any shoulder injury or ailment, it is well advised to regularly perform a few simple range-of-motion exercises to keep your shoulder muscles and tendons properly stretched and flexible to avoid recurrence or a frozen shoulder.
- If you are prone to shoulder issues, it may be a good idea to follow up your regular workouts with 15 minutes of massaging your shoulder area with an ice compress.
- Drink a few glasses of warm lemon water daily to prevent mineral deposits in the joints that can cause pain in your shoulder and other body parts.
Early Symptoms Of Frozen Shoulder
The full range of symptoms may arise over a period of around two years, but early symptoms include:
- pain in the shoulder, especially unexpected pain, when no known injury is present
- difficulty lifting ones arm above the head
- difficulty extending ones arm across the body or reaching behind the back
When To See A Doctor
If the pain on your shoulder is interfering with your daily activities, then it may be a good idea to see a doctor about it. Additionally, if the pain tends to worsen with even the slightest movement of the shoulder, then a consultation with an orthopedic specialist is warranted.
If the pain and discomfort continue to persist despite proper rest and care or spike to an unbearable degree, professional medical assistance must be sought for proper diagnosis and treatment.
Some worrisome symptoms that call for immediate medical help include:
- An arm that becomes incapacitated to the extent that you are unable to carry even light objects
- A severe injury that causes the joint to appear deformed
- Shoulder pain that is triggered at night or while resting
- Shoulder pain that persists beyond a few days
- Loss of mobility in the arm, including the inability to raise it
- Swelling or noticeable bruising around the joint or arm
- Signs of an infection, including fever, skin redness, and warmth
- Abdominal pain
- Labored breathing
More importantly, a sudden shoulder pain without any culpable cause or injury can be a telltale sign of a heart attack. If you experience any such unfounded discomfort, seek emergency medical help.
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What Kind Of Physical Therapist Do I Need
All physical therapists are prepared through education and experience to treat people who have frozen shoulder, or adhesive capsulitis. You may want to consider:
- A physical therapist who is experienced in treating people with orthopedic, or musculoskeletal, problems.
- A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in orthopaedic physical therapy, manual physical therapy, or specializes in the treatment of the upper extremity. This therapist has advanced knowledge, experience, and skills that may apply to your condition.
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when you’re looking for a physical therapist:
- Get recommendations from family, friends or other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapist’s experience in helping people with frozen shoulder.
- Be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.
About Trigger Points And Frozen Shoulder Syndrome
Myofascial trigger points in the muscles of the shoulder and surrounding areas can cause frozen shoulder.
Trigger points are muscle knots, lumps, or sensitive areas that can occur due to injury, overuse, or referred pain from another area of your body. They can cause pain, reduced mobility, and muscle weakness. Trigger points can also lead to poor circulation, contractions, and spasms.
There are certain trigger points connected to frozen shoulder. Learning about these specific areas may help you to understand how to treat frozen shoulder.
Trigger points related to frozen shoulder are found in any of the shoulder or arm muscles. These diagrams show the common trigger points for frozen shoulder .
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