Frozen Shoulder
Also called as Stiff shoulder/ Adhesive capsulitis, this condition is characterised by severely limited range of motion of the Shoulder joint which may be associated with shoulder pain. The basic pathology behind this condition is inflammation and thickening of the Shoulder joint capsule which makes the capsule tight leaving very less room for the movements to happen.
Signs and Symptoms
Symptoms of frozen shoulder are divided into three stages according to the stages of Adhesive capsulitis
- Freezing stage: In this stage, the shoulder becomes stiff and is painful to move. Pain is a predominant symptom and this stage may persist for 3-6 months.
- Frozen stage: In this stage, pain may lessen, but the shoulder remains stiff.
- Thawing (recovery) stage: In this stage, pain lessens, and ability to move the shoulder slowly improves. The whole duration for this cycle may last from 9 months to 2 years.
Risk Factors
- Trauma to shoulder
- Medical conditions like Diabetes Mellitus and Thyroid disorders
- Reduced mobility secondary to arm fractures , post stroke , post-surgeries like mastectomy
- Increased age
- Systemic diseases like Tuberculosis and Parkinson’s disease.
JEEVISHA protocol for management of Frozen shoulder:
Management of Frozen shoulder depends on the stage in which the patient first comes to us.
- Medications: In the initial course of the management of this condition, patients may be prescribed some Muscle relaxants. Some other medications may be prescribed depending on the condition of the patient, which is individualized from patient to patient basis.
- Physiotherapy: Physiotherapy plays a very important role in fighting these painful conditions. With a team of dedicated physiotherapist, patient is further evaluated and accordingly a plan is prepared for first reducing pain with different modalities and then slowly rehabilitating shoulder for normal functioning.
Targeted treatment
Treatment selection depends on the stage, severity and associated pathologies.
- Ultrasound guided Intra- articular injection
- Ultrasound guided Suprascapular nerve Pulsed radiofrequency ablation
- Fluoroscope guided Cooled radiofrequency ablation of Articular branches of shoulder joint
- Ultrasound guided Capsular release of the shoulder joint
- Ultrasound guided Platelet rich plasma injection