What is frozen shoulder?

Frozen shoulder, also called “adhesive capsulitis,” is an inflammatory condition of the shoulder that results in tightening of the shoulder capsular ligaments.  This results in a stiff and often painful shoulder and can make it difficult to perform normal activities of daily living.

What are the signs of frozen shoulder?

Pain and stiffness are the hallmark signs of a frozen shoulder and most commonly there is a loss of external rotation range of motion.  A frozen shoulder typically goes through three stages of symptoms that last for a variable period of time.  Stage I (Freezing Stage) is the first stage and is the most painful. There is a progressive loss of motion in the first stage that can last from 6 weeks to 9 months.  Stage II (Frozen) is characterized by a plateau of the pain and stiffness and can last from 4 to 12 months, or more.  Stage III (Thawing) is characterized by decreasing pain with a gradual return of motion and can last from 1 to 4 years without treatment.  Although frozen shoulder usually resolves on its own with time, permanent stiffness is possible. 

What causes frozen shoulder?

Frozen shoulder is often caused by an injury to the shoulder that leads to an inflammatory reaction and the resultant tightening of the shoulder capsule and ligaments.  It can also result from an injury elsewhere in the arm or hand if the arm is immobilized for a long period of time.  Other medical conditions are associated with frozen shoulder, but the relationship is not entirely clear.  These associated medical conditions include diabetes, respiratory/lung problems, adrenal disease, thyroid problems, recent chest surgery, and an extended hospitalization.  Regardless of the original cause, the synovial lining of the shoulder joint thickens, and the capsular ligaments contract, limiting the range of motion of the shoulder.

What are the treatment options?

Most cases of frozen shoulder can be successfully treated with anti-inflammatory medicines, a corticosteroid injection and a therapy program.  The medication and injection help to decrease the pain and inflammation, and the therapy helps restore range of motion.  Occasionally for severe cases, if these methods fail to resolve the frozen shoulder, a manipulation of the shoulder under anesthesia and/or surgery may be required to release the tight capsule/ligaments in the shoulder.  The surgery is typically performed arthroscopically with small incisions in a minimally invasive manner.

If you have signs or symptoms of frozen shoulder feel free to call our office to schedule an appointment with one of our fellowship trained Orthopaedic hand and upper extremity surgeons that specialize in both the non-surgical and surgical treatments of hand, wrist, elbow, and shoulder problems.

Article by Dr. George S. Edwards, III.

by ANDREA LUEKEN, OTR/L, CHT

As the weather gets better, many of us are spending more time outside. Gardening is a great hobby and a good way to stay active. Unfortunately, for those with hand arthritis, this hobby can be painful.  When activities you love cause pain, it’s time to think about what you can do to minimize pain and further damage to your joints.  The following tips can help you enjoy gardening for many years to come!

1. Plan ahead. Think about what activities may require help. If you are handling heavy plants or maneuvering pots, ask for assistance. You’ve heard the saying, “Two hands are better than one”. Well, for those with pain, four hands are better than two! If you use less effort on the heavier tasks, you can do more enjoyable activities like planting flowers and tending to your vegetables.

Planning ahead may also mean organizing your time. Trying to finish the whole garden in one shot may not be good for your joints! Make sure you take breaks and spread the project over several days to avoid unnecessary pain.

2. Finds tools to help your body work more efficiently. For those with arthritis in the hands, there are a variety of gardening tools to decrease strain on your joints. Typically, tools with wider grips and curved handles are better. These can help place joints in better positions for less pain, but also allow you to use larger muscle groups to do the work.

3.  Know your limits. If you are performing a task and it is painful, you probably shouldn’t be doing it! Is there a different way to complete the task which doesn’t cause pain (i.e. reposition hands/body, use different tool, etc). There is almost always more than one way to finish a project. And your joints with thank you when you find that way!

Arthritis can be painful and debilitating. But with the right tools and knowledge, gardening is one activity that you can enjoy for a long time! The following websites may be helpful in completing your goals.

www.arthritistoday.org

www.arthritissupplies.com

You can also speak with one of our hand therapists to help you determine the best way to enjoy these activities for years to come!