By Dr. Amod Manocha, Pain Management
Frozen shoulder is a painful condition in which there is a significant loss of motion of the shoulder joint in all directions, accompanied by stiffness. This occurs when the capsule surrounding the shoulder joint becomes thickened and tight thereby limiting the movements. The joint may lose some of its lubricating fluid, reducing the space for the arm bone to move. In medical term, it is known as “adhesive capsulitis”. It is seen more commonly in women over the age of 40 years. Diabetics and people with thyroid problems are more likely to develop this condition.
The treatment for a frozen shoulder is focused on relieving pain and restoring the shoulder movements. A pain clinic can play a significant role by prescribing medications, using timely interventions such as injections and providing supervised physiotherapy. Physiotherapy and injections combined may provide greater improvement than physiotherapy alone.
Injection options for shoulder joint include shoulder joint steroid injection or hydrodistension of the shoulder joint. These injections can help reduce pain and improve range of movement. These can be performed in OPD settings under ultrasound guidance. Ultrasound helps to improve accuracy, maximising the chances of you getting benefit from injections. Surgery is rarely necessary to treat frozen shoulder. It is considered when there is minimal improvement after 6 to 12 weeks of nonsurgical treatment. Physical therapy is an important component of treatment and should be performed under supervision. Always warm up your shoulder before performing your exercises. A warm bath or a moist heating pad can help with this.
- Towel Stretching: This is a simple exercise in which you hold one end of a towel horizontally behind your back and grab the other end with the other hand. Use the good arm, pull the towel, and the affected arm, up toward the shoulder. Repeat 10 to 20 times a day.
- Finger Walk: In this exercise, you stand facing the wall and keep moving your fingertips beginning from the waist level till the maximum level that you can reach out. Make sure that the work is done by your fingertips and not the shoulder muscles.
- Cross-body reach: Use your good arm to lift your affected arm at the elbow, and bring it up and across your body, exerting gentle pressure to stretch the shoulder.
- Pendulum stretch: Lean forward with the good hand resting on a table. Let the affected arm hang down vertically and swing in a small circle. Gradually increase the diameter as your arm becomes better.