Nov 09
10
Frozen shoulder or adhesive capsulitis as it is sometimes referred is characterised by a painful and stiff shoulder. Frozen shoulder is reported to affect 2% – 5% of the general population increasing to 10% to 38% in patients with a systemic condition like Diabetes Mellitus.
Individuals with primary frozen shoulder are usually aged between 40 and 65 years and the incidence appears higher in females than males. The occurrence of symptoms in one shoulder increases the risk of having it in the opposite shoulder by 5% to 34% and experiencing symptoms in both shoulders at the same time occurs as often as 14% of the time.
What is most perplexing is that we are still unclear as to the aetiology of frozen shoulder. Most symptoms are insidious by nature and are often not apparent in the early stages especially if the effected side is non dominant. There seems to be a relationship between systemic conditions like diabetes and an underlying connective tissue disease process leading to capsuloligamentous complex (shoulder joint) fibrosis and contracture (secondary frozen shoulder).
Those that research and report on Frozen Shoulder describe 3 stages of natural history; the painful or freezing stage, the stiff or frozen stage and the recovery or thawing stage. What is often devastating to those that have been given the diagnosis of frozen shoulder is the overwhelming fact that symptoms can last from 3 months to 2 years.
The definitive treatment for frozen shoulder remains unclear despite a plethora of interventions being studied. In the short term, corticosteroids injections have been shown to be effective despite the fact that some research has shown a complete lack of inflammatory cells in the capsular tissue inside the shoulder joint.
Appropriate and timely physiotherapy has been found to be successful in reducing pain, improving function and patient satisfaction. Physiotherapy treatment strategies based on shoulder irritability level include patient education, electrical stimulation (TENS), joint mobilisation and a low load prolonged stretching program. These interventions can be utilised across all 3 stages.
For those with Diabetes, what is required is a greater awareness of the insidious nature of frozen shoulder, early recognition of symptoms and a comprehensive management plan including both medical and allied health professionals including physiotherapists who are dedicated to the treatment of the shoulder.
Brisbane’s resident “Shoulder Guy” Luke Van Every knows all to well the effects of frozen shoulder. His new product range will include specific education and simple shoulder rehabilitation strategies to help those with symptoms of frozen shoulder get rid of their pain once and for all.
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