#2 Frozen Shoulder
Frozen shoulder is also known as adhesive capsulitis and is characterized by stiffness, pain, and limited range of motion in the shoulder joint. This condition typically develops gradually over time and takes one to three years for symptom improvement. The “freezing” of the shoulder results from the thickening of the shoulder joint capsule of connective tissue, causing it to tighten and restrict the shoulder joint. 13
Risk factors associated with frozen shoulder include 13
Reduced mobility from injury, surgery, or stroke.
Individuals over the age of 40 with women being more likely to be affected by the condition.
Diseases such as diabetes, hyperthyroidism, hypothyroidism, cardiovascular disease, and Parkinson’s.
40+
FROZEN SHOULDER SYMPTOMS Unlike other forms of shoulder pain, frozen shoulder symptoms typically present in a four-stage process. 14 Most therapy is supported during the early and thawing stages.
Stage One Early Stage (1 to 3 months)
Stage Three Frozen (9 to 15 months)
During this stage of the condition, range of motion is typically unaffected often resulting in the condition being misdiagnosed as shoulder impingement. Patients experience pain in the shoulder when at rest and at the end range of motion. Patients also tend to report difficulty sleeping. 14, 15
As the name of this stage suggests, range of motion is severely limited in all directions. Pain continues and can be a throbbing sensation for patients even at rest. The synovium becomes less inflamed, but it is replaced with capsuloligamentous fibrosis. 14,15
Stage Four Thawing (15 to 24 months)
Stage Two Freezing/ Painful Stage (3 to 9 months)
During this stage, symptoms begin to resolve. Both the synovitis and capsular fibrosis are diminished and patient pain improves. Mild pain and mobility deficits may persist for several years, but patients still tend to report improvement in function and are able to return to routine activities. 14,15 Physical therapy programs focused on joint mobility and restoring functional strength to the shoulder can be helpful during this stage.
By this stage, the synovium has become inflamed. Pain continues to increase and patients gradually lose range of motion in all directions. 14,15 Home exercise programs can be prescribed to help patients retain range of motion and reduce pain.
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