Frozen Shoulder Treatment Twyford

What is Frozen Shoulder (Adhesive Capsulitis)?

Adhesive capsulitis is a scar tissue-induced stiffness of the shoulder that causes pain and loss of motion. The exact cause of adhesive capsulitis is a point of contention. Some believe inflammation, such as when the lining of a joint becomes inflamed (synovitis), or autoimmune reactions, in which the body launches a “attack” against its own chemicals and tissues, are to blame. Other factors to consider are:

• After an injury or surgery, the body’s reactions.
• Other conditions that have caused a person to stop moving their shoulder, such as arthritis, a rotator cuff tear, bursitis, or tendinitis.
• After surgery or a fracture, immobilisation of the arm, such as in a sling.

Adhesive capsulitis, on the other hand, frequently occurs for no apparent reason.

Symptoms

Adhesive capsulitis causes pain to worsen and mobility loss in the majority of persons. There are four stages of adhesive capsulitis, and your physiotherapist can help you figure out which one you’re in.

Stage 1: “Pre-freezing”

It may be difficult to recognise your problem as adhesive capsulitis in the early stages of its growth. You’ve been experiencing symptoms for one to three months and they’re growing worse. Shoulder movement produces discomfort. It normally hurts while you’re not using it, but as you move around, the discomfort intensifies and becomes “sharp.” During this time, you’ll begin to minimise shoulder motion and protect the shoulder by using it less. The loss of mobility is most obvious in “external rotation” (when your arm is rotated out from your body), but it can also occur when you elevate your arm or reach behind your back. This stage is characterised by pain, which can occur both during the day and at night.

Stage 2: “Freezing”

You’ve probably been experiencing symptoms for 3 to 9 months, with a gradual loss of shoulder movement and an increase in pain (especially at night). Although the shoulder still has some range of motion, it is restricted by discomfort and stiffness.

Stage 3: “Frozen”

Your symptoms have been bothering you for 9 to 14 months, and you have a limited range of motion in your shoulders. There is still a significant degree of pain in the early stages of this cycle. However, as you get closer to the end of this stage, the pain will lessen, and you’ll only feel it when you move your shoulder as far as you can.

Stage 4: “Thawing”

You’ve been experiencing problems for 12 to 15 months and have noticed a significant reduction in discomfort, particularly at night. Although you still have a restricted range of motion, your ability to execute daily activities that require overhead mobility is rapidly increasing.

Injection Therapy For Frozen Shoulder

Injection therapy may be required if the pain persists and is interfering with your daily activities. Injection treatment is especially beneficial in the following circumstances:

• An ultrasound-guided steroid injection is the way to go if you’re in a lot of pain, especially if it’s waking you up numerous times a night. This claim is supported by medical research.
• Pain that keeps you from doing things like washing and dressing, cooking, or participating in recreational activities.
• Pain is interfering with your motivation to participate in physiotherapy rehabilitation.
• Hydrodilatation (Hydrodistenion of shoulder capsule): This procedure is performed under ultrasound guidance when shoulder is stiff but less painful. This procedure helps to stretch the capsule with high volume of steroid, lidocaine and saline.

According to a recent systematic analysis, steroid injections are the most effective treatment for frozen shoulder in stage one, the “painful stage” (Wang et al., 2016). Patients are having a terrible time finding pain relief at this point, and even tiny movements make the pain worse. It can take several hours or even days for discomfort to decrease when it becomes severe. Injections are used to reduce the pain and edoema associated with frozen shoulder. This provides you with a ‘great opportunity’ to correctly stretch your shoulder. For the best effects, physiotherapy should be started within two weeks of receiving a shoulder joint injection, according to studies.

Injections guided by ultrasound images are more successful at delivering medication to the shoulder joint, as well as reducing discomfort and improving function, than injections guided by landmarks (Daniels et al., 2018; Aly et al., 2015). According to study, ultrasound-guided injections can dramatically relieve the pain associated with frozen shoulder, especially in the short term. When injectable treatment and physiotherapy are combined, the results can be quite effective.