Frozen shoulder โรคไหล่ติด (Pain and/or Stiff)

Frozen shoulder is a prevalent condition. Patients frequently experience pain and limited shoulder range of motion, significantly impacting their work and daily activities. Today, we will explore this condition in more detail.

Etiology of disease

The etiology of frozen shoulder remains unclear; however, it is frequently associated with a previous shoulder injury or inflammation/degeneration of the shoulder tendons, which prompts the patient to limit movement on the affected side, finally resulting in frozen shoulder. This condition is particularly prevalent among diabetic patients with inadequate blood sugar control.

Symptoms of the condition encompass:

1.     Pain that progressively increases and may be more severe at night.

2.     The restriction of shoulder movement primarily forward flexion of the arm. This limitation occurs when both actively and passively move the arm.

It is frequently observed in person who

1.     Age 50-70 years

2.     More prevalent in women than in men.

3.     Have underlying conditions such as diabetes, thyroid disorders, and rheumatoid arthritis.

4.     Have a history of accidents or surgeries in the shoulder region.

5.     have a history of inflammation or degeneration of the shoulder tendons.


Stages of Frozen shoulder

Pre-freezing stage: The initial stage, lasting from 0 to 3 months, is characterized by pain and restricted movement of the shoulder joint, resulting from the onset of inflammation in the joint tissue.

Freezing phase: 3-6 months. The pain increases, joint movement becomes increasingly limited, the shoulder joint tissue experiences significant inflammation, and the shoulder joint begins to adhere.

Frozen Stage 9-15 months The pain will begin to decrease, yet the restriction of joint mobility will persist. Inflammation of the shoulder joint tissue will subside, although there will be an increase in scar tissue.

The thawing stage is characterized by the gradual improvement of all symptoms, including a reduction in pain and an increase in mobility.

(Reference: Neviaser Stages, 1945)

Treatment

Typically, frozen shoulder can resolve spontaneously within 18 to 24 months, a duration regarded as lengthy. In certain individuals, however, the pain may persist for over three years, resulting in prolonged discomfort. This condition can also lead to atrophy of the muscles surrounding the shoulder due to disuse. Consequently, if you suspect you have frozen shoulder, it is advisable to consult a physician for diagnosis and treatment at the earliest opportunity.

Treatment: In cases where symptoms are not severe, physical therapy may be applied to enhance the joint's range of motion. For more severe symptoms, VASU Pain Management offers a treatment involving glucose injections into the shoulder joint and tendons to release the adhesion (hydro dissection). This procedure utilizes ultrasound guidance to localize the needle for precise, safe, and effective injection. This method can shorten the time to recover from frozen shoulder.

However, frozen shoulder may presented with the symptoms similar to other conditions, such as tendonitis and myofascial pain in the shoulder region. To ensure effective treatment, it is advisable to consult a physician for a differential diagnosis and efficient treatment.