Frozen Shoulder (Adhesive Capsulitis)

What Are the Origin and Causes of Shoulder Problems?

The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. It is easily subject to injury because the ball of the upper arm is larger than the shoulder socket that holds it. To remain stable, the shoulder must be anchored by its muscles, tendons, and ligaments. Some shoulder problems arise from the disruption of these soft tissues as a result of injury or from overuse or underuse of the shoulder. Other problems arise from a degenerative process in which tissues break down and no longer function well.

Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Disease within the body (such as gallbladder, liver, or heart disease, or disease of the cervical spine of the neck) also may generate pain that travels along nerves to the shoulder.

How Are Shoulder Problems Diagnosed?

Following are some of the ways doctors diagnose shoulder problems:
· Medical history (the patient tells the doctor about an injury or other condition that might be causing the pain).

· Physical examination to feel for injury and discover the limits of movement, location of pain, and extent of joint instability.

· Tests to confirm the diagnosis of certain conditions. Some of these tests include:

· x ray

· arthrogram--Diagnostic record that can be seen on an x ray after injection of a contrast fluid into the shoulder joint to outline structures such as the rotator cuff. In disease or injury, this contrast fluid may either leak into an area where it does not belong, indicating a tear or opening, or be blocked from entering an area where there normally is an opening.

· MRI (magnetic resonance imaging)--A non-invasive procedure in which a machine produces a series of cross-sectional images of the shoulder.

What Is a Frozen Shoulder?

As the name implies, movement of the shoulder is severely restricted in people with a "frozen shoulder." This condition, which doctors call adhesive capsulitis, is frequently caused by injury that leads to lack of use due to pain. Rheumatic disease progression and recent shoulder surgery can also cause frozen shoulder. Intermittent periods of use may cause inflammation. Adhesions (abnormal bands of tissue) grow between the joint surfaces, restricting motion. There is also a lack of synovial fluid, which normally lubricates the gap between the arm bone and socket to help the shoulder joint move. It is this restricted space between the capsule and ball of the humerus that distinguishes adhesive capsulitis from a less complicated painful, stiff shoulder. People with diabetes, stroke, lung disease, rheumatoid arthritis, and heart disease, or who have been in an accident, are at a higher risk for frozen shoulder. The condition rarely appears in people under 40 years old.

What Are the Signs of a Frozen Shoulder and How Is It Diagnosed?

With a frozen shoulder, the joint becomes so tight and stiff that it is nearly impossible to carry out simple movements, such as raising the arm. People complain that the stiffness and discomfort worsen at night. A doctor may suspect the patient has a frozen shoulder if a physical examination reveals limited shoulder movement. An arthrogram may confirm the diagnosis.

How Is a Frozen Shoulder Treated?

Treatment of this disorder focuses on restoring joint movement and reducing shoulder pain. Usually, treatment begins with nonsteroidal anti-inflammatory drugs and the application of heat, followed by gentle stretching exercises. These stretching exercises, which may be performed in the home with the help of a therapist, are the treatment of choice. In some cases, transcutaneous electrical nerve stimulation (TENS) with a small battery-operated unit may be used to reduce pain by blocking nerve impulses. If these measures are unsuccessful, the doctor may recommend manipulation of the shoulder under general anesthesia. Surgery to cut the adhesions is only necessary in some cases.

The Frozen Shoulder Workbook: Trigger Point Therapy for Overcoming Pain and Regaining Range of Motion Author: Clair Davies NCTMB Description Author Clair Davies' own case of frozen shoulder led him to undertake an extensive study of trigger points and referred pain that eventually resulted in his best-selling Trigger Point Therapy Workbook...

Healthy Shoulder Handbook: 100 Exercises for Treating and Preventing Frozen Shoulder, Rotator Cuff and other Common Injuries Author: Karl Knopf Description END PAIN, REGAIN RANGE OF MOTION AND PREVENT RE-INJURYMillions of people suffer from debilitating shoulder problems every year. With Healthy Shoulder Handbook, you can take yourself off that list. This friendly manual outlines the causes for common shoulder conditions, including shoulder impingement, rotator cuff, tendinitis, dislocation and repetitive motion injuries...

The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition Author: Clair Davies Description The first edition of this workbook is regarded as a classic in its field, and was the first book to introduce trigger point therapy to the general public as a self-care tool for alleviating chronic pain caused by a variety of conditions, including arthritis, back pain, carpal tunnel syndrome, fibromyalgia, headache, muscle ache, and repetitive strain injuries...

Shoulder Pain? The Solution & Prevention, Revised & Expanded Author: John M. Kirsch M.D. Description This is a self-help book written by John M. Kirsch, M.D., an Orthopedic Surgeon for the public. It is the result of 25 years of research into a new and simple shoulder exercise program to treat and prevent rotator cuff tears, the impingement syndrome, and the ''frozen shoulder...

Shoulder Pain Gone in Just Days! Author: Rick Kaselj Description Do you have stubborn and ache shoulder pain that just seems to never go away? I can help you better understand your shoulder pain, explain to you what is going wrong, let you know what you can do and finally help that shoulder pain go away for good...

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