Frozen shoulder is pain and stiffness in the shoulder area which makes it difficult for the sufferer to move the shoulder joint or upper arm. This complaint can in progress for several months, even a few year.
The shoulder joint has a protective capsule in the form of interconnected connective tissue. The capsule protects the bones, ligaments, and tendons that make up the shoulder joint. Frozen shoulder It occurs when scar tissue thickens the protective capsule, limiting movement in the shoulder joint.
Frozen shoulder also called adhesive capsulitis. This condition generally appears and worsens slowly, then gradually improves on its own. However, the time it takes to heal is different for each person.
Reason and Risk Factors Frozen Shoulder
It is not known what causes frozen shoulder. However, there are several factors that can increase a person's risk of developing this condition, namely:
- Female gender
- 40 years and over
- Have a systemic disease, such as diabetes, Parkinson's disease, tuberculosis, heart disease, or a thyroid hormone disorder (hyperthyroid or hypothyroid)
- Experiencing immobility (being unable to move) for a long time, for example from a stroke, arm fracture, recovery after surgery, or injury to the arm rotator cuff (muscle around the shoulder)
Symptom Frozen Shoulder
FrOzen Shoulder can greatly interfere with the patient's activities. The following are some examples of movements that are difficult for sufferers to do: frozen shoulder:
- Putting on clothes
- Comb the hair
- Scratching the back
- Put on a bra
- Reaching for goods in high places
Symptom frozen shoulder it generally develops slowly in three stages, each of which can last for several months. The three stages are:
- First stage or freezing stage
This stage is characterized by pain every time the shoulder joint is moved, thus limiting movement. This period lasts 6–9 months.
- Second stage or frozen stage
The second stage is characterized by starting to reduce pain, but the shoulder joint becomes increasingly stiff and difficult to move. This period can last from 4 months to 1 year.
- third stage or thawing stage
The third stage is characterized by shoulder movement that begins to improve. This stage generally lasts 6 months to 2 years.
In some patients frozen shoulder, pain in the shoulder joint can get worse at night and even interfere with sleep.
When to go to the doctor
Although it can subside on its own, frozen shoulder can reduce the quality of life of the sufferer because it makes movement and activity disturbed. Therefore, patients are advised to consult a doctor, so that the doctor can provide treatment to relieve symptoms and speed up recovery.
Diagnosis Frozen Shoulder
The doctor will ask the patient about the symptoms experienced and the history of the disease they have. Next, the doctor will perform a physical examination of the patient's shoulder and arm in the following two ways:
- Ask the patient to move the arm and shoulder, to determine the reach of the patient's arm on active movement
- Ask the patient to relax the shoulder muscles and direct the patient's arm to a certain movement, to determine the reach of the patient's arm in passive movements
Doctors can generally determine frozen shoulder through the physical examination above. However, if necessary, the doctor will carry out supporting examinations, such as X-rays or MRI, to rule out the possibility that the patient's complaints are caused by other conditions, such as arthritis (arthritis).
Treatment Frozen Shoulder
There are several methods of treatment that can be given by doctors to deal with complaints caused by: frozen shoulder, that is:
Drugs
Medicines given by doctors aim to relieve pain and inflammation. Examples of drugs are aspirin, ibuprofen, and naproxen sodium. If the pain persists, the doctor may give a corticosteroid injection into the problem area of the shoulder.
Physiotherapy
Physical therapy (physiotherapy) aims to restore arm reach as much as possible. On physiotherapy for frozen shoulder, the patient will be taught movements that can help the recovery process. It is important to remember, treatment with this method requires the patient's commitment so that the results of therapy are maximized.
During physiotherapy sessions, doctors may also perform TENS (transcutaneous electrical nerve stimulation). TENS is an electrical therapy that is performed by sending a small electric current through electrodes that are attached to the skin. The electric current aims to block the nerve impulses that cause pain.
In addition to the above therapy, patients can also independently apply cold compresses on the shoulder for 15 minutes, several times a day. It is considered quite effective to relieve pain in the shoulder.
If physical therapy and medication don't help, your doctor may choose other procedures, such as:
- Mmanipulation joints shoulderShoulder manipulation is performed by giving general anesthesia first, so that the patient falls asleep and does not feel pain when the manipulation is performed. After the patient is under anesthesia, the doctor will move the patient's shoulder in various directions to relax the tense joint capsule tissue.
- Shoulder distensionShoulder distention is the procedure of injecting sterile water into the joint capsule. This procedure aims to stretch the capsule tissue of the shoulder joint and make it easier to move the joint.
- arthroscopyArthroscopy is performed by inserting a small camera device (arthroscope) through an incision around the joint. Arthroscopy aims to remove scar tissue and adhering tissue in the shoulder joint.
Complications Frozen Shoulder
Complications that may arise as a result of frozen shoulder is stiffness and pain in the shoulder that lasts a long time. In some cases, patients can experience stiffness or shoulder pain for up to 3 years despite receiving medication.
Complications can also occur from shoulder manipulation, such as fractures of the upper arm (humerus) or tears in the muscles of the upper arm.
Prevention Frozen Shoulder
For patients who are in the process of recovering from injury or surgery, it is recommended to always move the arm to prevent this from happening frozen shoulder. If it is difficult to move the shoulder, discuss with your doctor about the types of movements you can use to maintain range of motion of the shoulder.
In addition, stroke patients are also advised to immediately run physiotherapy after a stroke. This is to prevent stiffness in the shoulder joint and other affected joints.