Frozen shoulders are considered one of the most challenging conditions. Contrary to the misconception that they resolve on their own without intervention, these conditions often require careful management and intervention. In this article, we take a closer look at the diagnosis and management strategies for frozen shoulder.
Frozen shoulders can affect people of different age groups and backgrounds, but several risk factors increase the likelihood of developing this condition. Primary capsular inflammation affects 2-5% of the population and secondary capsular inflammation due to thyroid disease or diabetes has a prevalence as high as 4-38% per cent, which is exceptionally high. There are some other risk factors. Patients with a history of Dupuytren's disease are also at increased risk. Frozen shoulders are often characterised by gradual stiffening and increasing pain over time.
The condition progresses through several proposed phases:The early phase is characterised by sharp pain with movement, painful pain at rest and sleep disturbances. The second and third phases are accompanied by loss of movement in all planes and may last several months. Histologically, there is a difference between the two, but not clinically. In the fourth stage, pain subsides but stiffness may persist for up to 24 months. Still, not all patients will be symptom-free after two years. The typical duration of a frozen shoulder is 30 months, but 50% of people continue to experience mild to moderate impairment years after the condition first manifests itself.Treatment approaches for frozen shoulder:
There are several treatment options for frozen shoulder. But which is effective? Patients should be educated about the natural history of frozen shoulders and the importance of adjusting their activities to promote a pain-free range of motion. Steroid injections(first 12 weeks), combined with shoulder mobility and stretching exercises, are most strongly recommended for short-term pain relief. Stretching exercises should be tailored to the degree of irritability. Exercise therapy should be tailor-made for each person.
