Frozen Shoulder Treatment in Indore

What Is Frozen Shoulder? 

Adhesive capsulitis (also called frozen shoulder) is a condition characterized by stiffness and pain in the shoulder joint. Inflammation and thickening of the shoulder capsule (the tissue surrounding the joint) results in adhesions (scar tissue that glues the structures together) and that limits shoulder motion. 

The disease is a slow disease and usually goes through different stages. At first, pain is predominant followed by progressive loss of motion. During the frozen stage, pain may subside somewhat but there is tremendous stiffness. Finally, the THAWING phase starts and there is a slow improvement of the motion over months. 

Frozen shoulder is more common in women, between 40-60 years of age and is found more often in people with diabetes, thyroid disorders or previous shoulder injury. 

Symptoms of Frozen Shoulder 

Usually the first symptom is pain in the shoulder, which is worse when lying in bed at night and as one moves. In a few cases the pain slowly increases and is constant. 

Loss of ROM is gradual and marked. Over time, patients will progressively begin to lose the ability to move the shoulder in various directions. Turning inwards and outwards is very limited and there are few options for doing things like reaches across the body or behind the back. 

Patients can’t comfortably sleep on the affected shoulder, dress themselves, or comb their hair. Simple activities are really difficult to do. 

As the freezing proceeds, the stiffness increases steadily until at the peak of the freezing period, it starts to improve slowly. 

Diagnosis of Frozen Shoulder 

Restricted PROM and AROM in multiple planes. Normally the x-rays will be normal and obtained to exclude other pathology like arthritis or fracture. 

MRI reveals thickening and inflammation within the capsule, which is associated with frozen shoulder, but is not required for diagnosis. 

Diagnosis will usually be straightforward as the signs and symptoms are progressive and clinical. 

Phases of Frozen Shoulder

Freezing stage (0-3 months) has progressive loss of motion and increase in pain. The frozen phase (3-9 months) is when there is severe stiffness and pain that gradually improves. The thawing phase (9-24+ months) is characterised by slow improvement in movement and recovery continues. 

Typical resolution is 12 to 24 months, but in some patients, there may be some remaining stiffness that will last a long time. 

Conservative Treatment of Frozen Shoulder 

Physical therapy is the main form of treatment. Gentle range of motion and stretching exercises are performed by therapists to maintain and restore motion and help control pain. 

Daily home exercise programs are imperative. Progressive motion and pendulum exercises and gentle stretching prevent further stiffness. 

NSAIDs (nonsteroidal anti-inflammatory drugs) help to decrease pain and inflammation, which helps to improve participation in therapy. 

Corticosteroid injections are effective in alleviating pain and inflammation, especially in the early stages. Several injections might be required. 

The use of moist heat prior to therapy and icing following activity helps to control pain and swelling. 

It is important that the patient be educated about the self limiting nature of the condition and realistic expectations for recovery. 

Surgical Treatment of Frozen Shoulder 

Arthroscopic release of adhesions is indicated for patients with a frozen shoulder that fails conservative treatment after 6-12 months or in patients who are unable to tolerate long periods of conservative therapy. 

This is done by arthroscopic visualization and gentle breaking up of any adhesions that restrict motion, especially in the rotator interval and axillary pouch (lower joint recess). 

Aggressive rehab is crucial after surgery, without it, the benefits of surgery will be lost. 

Success rates are good when combined with aggressive post-operative therapy;  poor outcomes result if post-operative therapy is inadequate. 

Outcomes of Treatment 

Conservative treatment alone provides satisfactory motion and pain relief to most patients (90+%) in 12-24 months. 

Some patients can have residual stiffness even after all symptoms have resolved; some patients may have less than normal motion. 

The combination of early aggressive physical therapy and injections, combined with the appropriate home exercise program, speeds recovery. 

Surgery is used to supplement conservative therapy if it has failed to work in refractory cases. 

Prevention of Frozen Shoulder 

Shoulder injury or surgery with early mobilization decreases the risk of frozen shoulder. In order to break up prolonged immobility if possible, this is important.

Diabetes and other risk factors decrease the incidence of frozen shoulder. 

After shoulder trauma, gentle range of motion exercises are helpful to keep the shoulder moving and to prevent the formation of adhesion. 

Why Dr. Sanjay Rawat is the best choice for Frozen shoulder treatment? 

Dr. Sanjay Rawat is an expert in comprehensive management of frozen shoulder, both conservatively and surgically. He has specialized knowledge in careful diagnosis, proper injection technique, surgical release when necessary and planning for rehabilitation.