By Dr. Surjeet Kaur, Trichology
Frozen shoulder is also known as adhesive capsulitis. It presents with pain and stiffness in the shoulder joint. Over a period of time, the shoulder becomes very difficult to move. Treatment usually has a focus on shoulder flexibility. Diabetics are more prone towards frozen shoulder.
The shoulder is a ball-and-socket joint. Strong connective tissue, called the shoulder capsule, surrounds the joint. For easy shoulder movement, synovial fluid provides lubrication to the shoulder capsule and the joint.
In cases of frozen shoulder, the shoulder capsule becomes thick, stiff and tight. Thick bands of tissue – called adhesions – develop. In most of the cases, amount of synovial fluid gets reduced in the joint. The classical signs of this condition are severe pain. There is difficulty in voluntary as well as assisted movement of shoulder.
A few medical conditions may at risk for developing frozen shoulder:
Frozen shoulder occurs much more often in people with diabetes. Other than diabetes, hypothyroidism, hyperthyroidism, Parkinson’s disease, and cardiac disease are few diseases which can contribute to worsening of Frozen Shoulder.
Physical immobility can also give rise to frozen shoulder. For example – a shoulder has been immobilized for a period of time due to surgery, a fracture, or other injury. Having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent frozen shoulder.
Pain from frozen shoulder is usually dull or aching. It is typically worse early in the course of the disease and when you move your arm. The pain is usually located over the outer shoulder area and sometimes the upper arm.
Few tests to rule out other causes of stiffness and pain include:
X-rays, Magnetic resonance imaging (MRI) and ultrasound.
The focus of treatment is to control pain and restore motion and strength.
Most people with frozen shoulder improve with relatively simple treatments to control pain and restore motion. Non-steroidal anti-inflammatory medicines. Drugs like aspirin and ibuprofen reduce pain and swelling.
Steroid injections: Cortisone is a powerful anti-inflammatory medicine that is injected directly into your shoulder joint.
Hydrodilatation: If symptoms are not relieved by other nonsurgical methods, hydrodilatation is recommended.
Physical therapy: Specific exercises will help restore motion. Sometimes heat is used to help loosen the shoulder up before stretching.
If symptoms are not relieved by therapy and other conservative methods Surgery for frozen shoulder is typically undertaken. The goal of surgery is to stretch and release the stiffened joint capsule. The most common methods include manipulation under anesthesia and shoulder arthroscopy.
Long-term outcomes after surgery are generally good, with most patients having reduced or no pain and improved range of motion. In some cases, however, even after several years, the motion does not return completely and some degree of stiffness remains. Diabetic patients often have some degree of continued shoulder stiffness after surgery.
Although uncommon, frozen shoulder can recur, especially if a contributing factor like diabetes is still present.
Can Ayurveda treat a frozen shoulder?
In Ayurveda, frozen shoulder is called Avabahuka. Vata Dosha triggers it. Kapha Dosha causes the stiffness of joints. Because of this particular dosha, people with frozen shoulder experience a sharp increase in pain in cold or wet weather.
There are several Ayurvedic therapies, which can allay the pain and stiffness of frozen shoulder-
• Abhyanga - There are medicated oils that can reduce the pain and inflammation when massaged on the shoulder. Heat the oils before you use them. Some oils that you can use are vishagarbha oil, mahanarayana taila, dhanvantara taila, kottamchukkadi thailam, bala taila or prasarinyadi taila.
• Elakizhi - This is a herbal poultice made with castor leaves, dashamoola, nirgundi, devadaru, etc. All of them help to balance out Vata Dosha.
• Navarakizhi - This treatment starts with the abhyanga oil massage. After that, a rice pack is dipped in the same oil and applied to the site.
• Lower your blood sugar - Sometimes high levels of blood sugar in the system can lead to frozen shoulders. Haridra and amlaki powder help bring down blood sugar levels. Few other Ayurved medical Prescriptions can help reduce the blood sugar values.
• Exercise - Ayurvedic medication and therapy become much more effective when you pair them with recommended exercise. Exercise increases the blood flow to the shoulder.
• Ayurved Agnikarma - Agnikarma (therapeutic cauterization) is very effective and unique Ayurvedic procedure which helps in providing instant pain relief, especially in Frozen Shoulder. Agnikarma is recommended in all painful conditions which are caused due to vata and kapha.
Frozen shoulder is not fatal and goes away on its own in a few years. However, if the symptoms are troubling your day-to-day activities, you should consider following the above therapies. Ayurveda can help treating frozen shoulder much sooner and help you get back to your everyday routine.