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Frozen Shoulder?
4 Replies
vavaughn - March 21

I have heard of frozen shoulder but am not sure what it is. I am suffering immensely from pain under my left shoulder blade. It is made worse by turning my neck or lifting either of my arms. Does this sound like frozen shoulder? Does anyone know what the most effective treatment is if the normal pain meds are not taking away the ridiculous level of pain!

 

Fantod - March 21

A frozen shoulder is a shoulder joint with significant loss of its range of motion in all directions. The range of motion is limited not only when the patient attempts motion, but also when the doctor attempts to move the joint fully while the patient relaxes. A frozen shoulder is also referred to as adhesive capsulitis.


What causes a frozen shoulder?

Frozen shoulder is the result of inflammation, scarring, thickening, and shrinkage of the capsule that surrounds the normal shoulder joint. Any injury to the shoulder can lead to frozen shoulder, including tendinitis, bursitis, and rotator cuff injury. Frozen shoulders occur more frequently in patients with diabetes, chronic inflammatory arthritis of the shoulder, or after chest or breast surgery. Long-term immobility of the shoulder joint can put people at risk to develop a frozen shoulder.


How is a frozen shoulder diagnosed?

A frozen shoulder is suggested during examination when the shoulder range of motion is significantly limited, with either the patient or the examiner attempting the movement. Underlying diseases involving the shoulder can be diagnosed with the history, examination, blood testing, and x-ray examination of the shoulder.

If necessary, the diagnosis can be confirmed when an x-ray contrast dye is injected into the shoulder joint to demonstrate the characteristic shrunken shoulder capsule of a frozen shoulder. This x-ray test is called arthrography. The tissues of the shoulder can also be evaluated with an MRI scan.


What conditions can mimic a frozen shoulder?

Inflammation of the shoulder joint (arthritis) or the muscles around the shoulder can cause swelling, pain, or stiffness of the joint that can mimic the range of motion limitation of a frozen shoulder.

Injury to individual tendons around the shoulder (tendons of the rotator cuff) can limit shoulder-joint range of motion, but usually not in all directions. Often during the examination of a shoulder with tendon injury (tendinitis or tendon tear), the doctor is able to move the joint with the patient relaxed beyond the range that the patient can on their own.


How is a frozen shoulder treated?

The treatment of a frozen shoulder usually requires an aggressive combination of antiinflammatory medication, cortisone injection(s) into the shoulder, and physical therapy. Without aggressive treatment, a frozen shoulder can be permanent.

Diligent physical therapy is often key and can include ultrasound, electric stimulation, range-of-motion exercise maneuvers, ice packs, and eventually strengthening exercises. Physical therapy can take weeks to months for recovery, depending on the severity of the scarring of the tissues around the shoulder.

It is very important for people with a frozen shoulder to avoid reinjuring the shoulder tissues during the rehabilitation period. These individuals should avoid sudden, jerking motions of or heavy lifting with the affected shoulder.

Sometimes frozen shoulders are resistant to treatment. Patients with resistant frozen shoulders can be considered for release of the scar tissue by arthroscopic surgery or manipulation of the scarred shoulder under anesthesia. This manipulation is performed to physically break up the scar tissue of the joint capsule. It carries the risk of breaking the arm bone (humerus fracture). It is very important for patients that undergo manipulation to partake in an active exercise program for the shoulder after the procedure. It is only with continued exercise of the shoulder that mobility and function is optimized.

Frozen Shoulder At A Glance
Frozen shoulder is the result of scarring, thickening, and shrinkage of the joint capsule.
Any injury to the shoulder can lead to frozen shoulder.
A frozen shoulder is usually diagnosed during an examination.
A frozen shoulder usually requires aggressive treatment.

 

vavaughn - March 21

Fantod -- as always, thank you for the detailed information. Frozen shoulder does not sound like what is going on with me. I haven't lost mobility. It may hurt like the dickens to move but it still moves. Frozen shoulder sounds absolutely horrible! I'm glad that I don't believe that is what I am working with. It does sound like it could be one of the mimicked conditions. I was just got a diagnosis of OA in my ankles and my knees so I am guessing it is possibly in my shoulder as well. I go to the rheumatologist this week. I will be sure to mention it to her. Thank you again! You are a wealth of information!

 

Fantod - March 21

You are very welcome. I'd like to suggest that you consider seeing an orthopedist that specializes in shoulders. Whatever is going on needs to be addressed by the proper medical professional.

If heat is helpful, try a stick on patch so that you can go about your normal business and not be tethered to a heating pad. I like the heat patches specifically made for menstrual pain. They are not as bulky and seem to stay where you put them.

Good luck and feel better.

 

January - March 21

Hi Vavaughn -

Don't know if I understand you completely, but what you seem to be describing sounds like more than a shoulder joint problem - though you could have a couple things happening at once. Do you know if you have injured the vertebrae of your neck? The nerves there can cause pain that radiates to other areas. I think the best diagnostic test for herniated disks and stenosis is an MRI.

With the pain, you probably have severely cramped muscles too. Early in my fibro journey I had terrible pain under my shoulder blades - it turned out the muscles in my back were knotted up and I didn't know. The knots were cured with deep massage and lidocaine injections.

I'm having problems in my shoulder joint too. it's true, the pain level can be off the charts sometimes! I am eating lots of pineapple (thank you Fantod) and trying to exercise my shoulder as I can tolerate. Seems better than it was, except for flare ups. I just started taking serrapeptase in case it is capsulitis. I can't tolerate the usual medical procedures -- but if it's a problem with nerves in your neck, they will probably offer you cortisone. You might want to research that. Fantod posted some good information for me when I first got my shoulder problem - including information about something called Sarapin - which is an injection that might work better than cortisone. The Wall Street Journal published some research that cortisone injections help short term, but long term, can make the pain worse, and can damage the tendons. Cortisone is not good for your bones either, but we all have to make decisions on what we can tolerate. Guess you need a good diagnosis first, so good luck to you! And hope you feel better.

 

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