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 WHAT IS A FROZEN SHOULDER?



A frozen shoulder is a condition where the ball and socket joint of the shoulder freezes. This causes loss of motion with stiffness in all directions.


WHAT CAUSES A FROZEN SHOULDER?


The cause of a frozen shoulder is not fully understood. It is due to the formation of scar tissue within the ball and socket joint and contraction of the sac around this joint. It is far more common in people who suffer from diabetes but can also occur with other medical conditions like thyroid disease, cardiac disease and following surgery.



WHAT ARE THE SYMPTOMS?

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The main symptom of a frozen shoulder is the inability to move the arm. This causes considerable difficulty with simple activities like putting hand to mouth, reaching behind or the top of the head. This stiffness is very painful. The pain is at the front of the shoulder and can be dull, aching and constant in nature. The pain is worse at the extremes of motion and night pain is very common    


HOW IS THIS DIAGNOSED?


 

A frozen shoulder is usually diagnosed by taking a good history and performing an examination. Active and passive movements are the same

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WHAT IS THE TREATMENT?

 

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 Frozen shoulders often get better by themselves. As this can take a very long time, sometimes years, there are other methods of improving the situation more quickly. The first method of treatment is to improve the pain with painkillers and injections and to improve the movement with physiotherapy. If these methods fail a procedure known as a distention arthrogram is adopted. Here the radiologist injects the shoulder, under x-ray control, and distends it with air or fluid. The idea is that this would break down the scar tissue within the joint and stretch the sac making it easier for the shoulder to move. It is important to have intensive physiotherapy once this is done to maintain the movement regained.

If this fails the next procedure is to manipulate the shoulder when the patient is asleep. Forcing the shoulder causes the scar tissue to tear. Once again it is important to have physiotherapy to maintain the movement achieved under the anaesthetic.

The final method of treatment is to put a telescope inside the shoulder to divide the scar tissue. This method provides the best results and the quickest return to normal movement.