16 Dec FROZEN SHOULDER

Frozen shoulder is a one of the most common problems affecting the age group from 40 to 60 years of age especially Diabetic patients.

As the name implies the joint just gets frozen that is becomes stiff .This happens particularly in shoulder as this one joint has bulky soft structures around it which support in its global multidirectional mobility.

And as the soft tissue thickens the joint becomes stiff with global restriction of mobility of shoulder. The stiff band of tissue called adhesions develop .Hence the frozen shoulder is called otherwise as adhesive capsulitis.

Though the exact etiology is not yet clear but it is commonly seen in people with Diabetes (sugar), Thyroid, Parkinsons disease.

There are three stages in the ongoing pattern of this disease which extends from Inflammation or the angry frozen stage to healing and recovering stage.

There are three stages in the ongoing pattern of this disease which extends from Inflammation or the angry frozen stage to healing and recovering stage.

Rotator Cuff Tears

How do we diagnose this condition?

It’s by clinical correlation along with X-ray of the shoulder which can help to find out additional problems like sharp bony edges or an MRI locate Additional soft tissue tear or leision Physical therapy does very good pain and stiffness relief, provided patient is patient enough for the recovery .The most common restriction of movement is external rotation and passive stretch as shown below gives adequate stretch.

Forward flexion lying down and trying to reach over head as shown below

Cross arm stretch exercise

Local infilteration of steroid may arrest the progression of the inflammatory process

If the symptoms does not improve

Mobilisation under anesthesia or Shoulder Arthroscopic capsular release is done

Image shows the normal shoulder on left and the angry inflamed frozen shoulder on right side

In this the thick sheath is released using a pencil like controlled thermal ablation and the movement is achieved in the operation theatre.

After surgery physical therapy is essential to maintain the range of motion achieved during the surgery. Long term out come of surgery is generally good with good range of motion and pain relief .However in some patients some amount of stiffness can be persisitant for several years.

If the pre existing conditions are not under control there can be recurrence.

                         Thanks & Regards,

                                                                       Dr.Naveen Thiyagu Bashingam

                                                                                                (Gold Medalist)

                                                                                            Senior Consultant Joint Replacement Surgeon

                                                                                                                     Alpha Ortho Clinic, Puducherry.

Authors Profile:

He is Gold Medalist, Triple Fellowship (Super Specialisation) holder. One fellowship from India and the other two from Germany. He is a passionate person and follows latest evidence based medicine approach in Joint Replacement Surgeries. Also he is a pioneer in Computer Navigation Joint Replacement surgery.

For further info check the website: www.alphaothoclinic.com / www.drnaveenthiyagu.com

Book for Appointment: 0413 2221855 / 90035 48023