What is a Frozen Shoulder?
Frozen shoulder, also called adhesive capsulitis, is a condition that causes stiffness and pain in the shoulder joint that gradually worsens over time, limiting the range of motion. Common in people aged 40 to 60 and more prevalent in women, the exact cause is unclear but is often linked to prolonged immobilisation, diabetes, thyroid disorders, and other systemic conditions. Effective management, whether through medication or surgery, is necessary for reducing pain, improving mobility, and aiding recovery.
Non-Surgical Treatment
Physical Therapy
A structured physical therapy program includes exercises to improve range of motion, reduce stiffness, and prevent further adhesion formation. It is often the first line of treatment before considering more invasive options.
Medication
Over-the-Counter Pain Relievers
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin can manage mild to moderate pain and inflammation. NSAIDs facilitate daily activities and physical therapy but long-term use carries risks like gastrointestinal and cardiovascular issues.
Prescription Medications
For severe pain, doctors may prescribe stronger medications, such as oral corticosteroids, which reduce inflammation and improve mobility but are typically used short-term due to risks like weight gain and osteoporosis.
Steroid Injections
Corticosteroid injections deliver anti-inflammatory medication directly into the shoulder joint, suppressing the inflammatory response. While steroid injections improve mobility and reduce pain, their use is limited due to risks such as infection, tendon weakening, osteoporosis, and temporary elevated blood sugar levels.
Surgical Treatment
Manipulation Under Anaesthesia
Manipulation Under Anaesthesia (MUA) is a procedure used to treat a frozen shoulder by breaking up adhesions and improving range of motion.
The Procedure: The patient is placed under general anaesthesia, and the surgeon manipulates the shoulder joint through its range of motion to break up scar tissue and adhesions. This procedure aims to restore mobility and reduce pain.
Benefits and Risks: While MUA can result in an immediate increase in shoulder mobility, there is a risk of fractures, ligament tears, and the possibility of not achieving the desired range of motion. Post-procedure pain and swelling are also common.
Recovery and Rehabilitation: Recovery from MUA typically involves physical therapy to maintain and improve the range of motion gained during the procedure. Rehabilitation is necessary to prevent adhesion recurrence and achieve long-term improvement.
Arthroscopic Surgery
Arthroscopic surgery is a minimally invasive option for cases where non-surgical treatments have failed to improve shoulder mobility and pain. It is also considered if the condition significantly impairs daily activities.
The Procedure: Small incisions are made to insert a camera and surgical instruments into the shoulder joint. The surgeon then removes scar tissue and adhesions, which allows for increased mobility.
Recovery and Rehabilitation: Recovery involves physical therapy to improve shoulder function and mobility. Patients typically experience less pain and recover faster than with open surgery. Regular follow-ups are necessary to monitor progress and address any complications.
When to Seek Medical Help?
Seek medical help if you experience persistent or worsening pain that does not respond to over-the-counter medications or if your shoulder mobility is significantly reduced, making daily activities difficult. If the pain disrupts sleep or normal functioning, an evaluation by a doctor is required. Timely medical consultation is necessary to diagnose frozen shoulder early and ensure proper management.
Conclusion
A frozen shoulder can severely impact daily life with pain and limited mobility. Non-surgical treatments, including physical therapy, medications, and injections, often provide relief, while surgery may be needed for severe cases. Prompt medical attention and adherence to treatment plans are key to recovery. Staying active, avoiding prolonged immobilisation, and consulting with a professional for persistent symptoms can help manage and improve shoulder function.
For personalised advice and effective treatment for shoulder conditions, including frozen shoulder, schedule a consultation with Dr LS Wang today.
