Frozen shoulder syndrome, or FSS, is a painful condition causing night pain and a restricted shoulder range of motion. Medical treatments for FSS often include stretching or injections of medications and steroids. Unfortunately, these treatments do not always provide lasting results in many patients.
The symptoms of a frozen shoulder syndrome are pretty obvious, and they make the need for treatment that much more immediate. A frozen shoulder syndrome tends to develop throughout three stages. The first stage is known as the freezing stage. It is when the pain and immobility begin to make itself well known to the patient. Generally, almost any movement of the shoulder will cause pain at this stage. Since many people tend to avoid getting treatment at this stage, hoping that it will just go away with time, the shoulder tends to progress into the full frozen stage. The exciting part about this stage is that physical pain tends to go away at this point, which leads to a false sense of relief and security for the patient.
Unfortunately, this relief tends to be very short-lived, since the shoulder quickly becomes completely stiff, to the point where any movement is either excruciating or downright impossible. It is the stage when patients tend to realize that something is wrong in their shoulders, and they start to seek out professional medical help as a result. Once a patient receives the proper diagnosis of a frozen shoulder syndrome, they can begin to start getting the treatment they need to restore mobility and relieve the pain, stiffness, and discomfort in the area.
History of Frozen Shoulder Syndrome
It doesn’t matter if you heard that you have a frozen shoulder syndrome or adhesive capsulitis. Both names are not an accurate representation of the frozen shoulder as we know it today.
The first description of what might have been a frozen shoulder syndrome was published in a report by Duplay in 1875. The term frozen shoulder was coined much later by Codman in 1934. He defined it as a painful shoulder condition, with limitations in elevation and external rotation. According to him, patients usually feel the pain near the deltoid insertion.
Today, frozen shoulder syndrome goes by different names – adhesive capsulitis or even arthrofibrosis. The term “adhesive capsulitis” was introduced in the United States when Neviaser in 1945 argued that the word “frozen shoulder” was a misnomer. His reason was that frozen shoulder was not cold but, in fact, hot. He was referring to the warmth that is associated with the inflammation process associated with the condition.
Interestingly enough, it was Neviaser himself who later found NO adhesions in the “frozen shoulders” he operated on. Today, there are multiple definitions of what is a frozen shoulder syndrome.
From a clinical perspective, it refers to a painful shoulder condition that is characterized by stiffness and a significant loss of range of motion – typically in external rotation. One of the outstanding complaints when it comes to adhesive capsulitis is shoulder pain when lifting arm.
What are the symptoms of Frozen Shoulder Syndrome?
There are three stages of Frozen Shoulder Syndrome:
Initially, there is a progressive limitation of all movements of the shoulder. It may follow a recent minor trauma, dislocation, prolonged immobilization, heart attack, and sometimes neck problems. Pain may or may not accompany this, although the pain will still exist if you try to exceed the limited movement. This phase can last anywhere between 2 and 9 months.
As the fluid in the joint becomes thickened, there may be more pain, and eventually, the condition progresses until all movement is greatly restricted. This phase can last from 4 to 12 months.
As the inflammation begins to subside, so does any pain experienced. During this phase, movement in the shoulder starts to return gradually but may or may not recover 100% if left untreated. This phase characteristically lasts between 6 to 9 months.
Chiropractic care has a scientific basis and explained to be one of the most effective and safe, not to mention completely natural methods used to treat cases of frozen shoulder syndrome. A chiropractor will work to use applied pressure to the joints near the shoulder to gradually restore mobility and decrease discomfort in the area. With time and proper treatment, the patient enters the final stage, known as the thawing out stage, where the shoulder’s range of motion begins to improve.
Early diagnosis is vital because the condition is reversible. Once it has progressed into the adhesive/frozen stage, some persistent restrictions may remain. The recovery period varies depending on how long the problem has been there and the severity of it. It is not uncommon for it to take up to 6 months to recover with treatment and up to 12-24 months without treatment. But as other shoulder problems are often labelled ‘frozen shoulder,’ it is crucial to have your shoulder examined for an accurate diagnosis and treatment.
Causes of Frozen Shoulder
Rotator Cuff Tendinitis/Tear
The rotator cuff muscles play an essential role in the movement of the shoulder. They consist of the supraspinatus, infraspinatus, and teres minor muscles. The rotator cuff tendon is a significant source of pain and disability. If it becomes inflamed (tendonitis) or torn, voluntary abduction, elevation, and rotation of the shoulder are lost.
However, the chiropractor will be able to move the shoulder, noting only a slight loss in movement due to pain. Whereas with a frozen shoulder syndrome, the chiropractor will not be able to move the joint. Rotator cuff muscle pain is usually due to trauma or overuse movements.
Bursas are fluid-filled sacs that surround certain joints of the body and act to prevent excess friction between tissues and bony surfaces. In the shoulder, you will find the subdeltoid bursa that lies underneath the deltoid muscles. These muscles make the rounded shape of the shoulder/arm.
The bursa can become inflamed (bursitis) or pinched, which in turn will produce pain and some limited movement of the shoulder. It will make the patient feel light swelling and heat production.
Referred pain from the neck
It is one of the most common coexisting causes of shoulder pain seen in chiropractic practice. When the spinal joints are sprained and become inflamed and irritated in the neck, it automatically triggers muscle spasm. It affects the muscles with the same nerve supply relating to the level that was injured. Pressure may also occur on the surrounding nerve fibers, but that is less common.
The nerves supply information to the muscles of the shoulder, and if these nerves become inflamed, the muscles go into spasm and weaken, and subsequently, the movement will be affected. Even low-grade increase of muscle tension, due to neck problems, makes you more likely to develop shoulder pain and problems. Chiropractic treatment can help this.
Other causes of Frozen Shoulder Syndrome
- Fractures and dislocation will cause pain, but due to the severity of these problems, the A & E departments in hospitals treat them.
- Arthritis of the shoulder joint, natural wear and tear, will produce shoulder pain, but usually, you will have experienced previous problems.
- Gallbladder inflammation (cholecystitis) can refer pain into the right shoulder joint but with no loss in the actual movement of the shoulder joint.
- Heart attacks can refer pain to the left shoulder and arm.
Treatment for Frozen Shoulder
Most treatments for frozen shoulder syndromes focus on preserving the joint’s range of motion and minimizing pain. Over the counter medications like ibuprofen and aspirin are usually the first line of defense. They help reduce inflammation and pain. However, in more severe cases, a doctor may prescribe anti-inflammatory drugs and pain medication. Physical therapy may also be an option.
Other treatments for Frozen Shoulder Syndrome include:
- Shoulder manipulation – while the patient is under a general anesthetic, the doctor moves the shoulder to loosen the tightened tissue.
- Joint distension – sterile water is injected into the joint capsule. It stretches the tissue and improves the range of motion.
- Steroid injection – corticosteroids are injected directly into the shoulder joint.
- Surgery – this is the last resort, so it’s seldom, but the doctor may go in and remove the adhesions and scar tissue from inside the shoulder joint.
Chiropractic for Frozen Shoulder Syndrome
Chiropractic is an effective treatment for frozen shoulder syndrome. Many patients see their general practitioner first to get a diagnosis and to make sure that there are no underlying untreated conditions before pursuing chiropractic. However, most chiropractors do have the capability to use x-rays and other diagnostic tools to assess the patient adequately.
A 2012 study involved reviewing the case files of 20 males and 30 female patients with a frozen shoulder syndrome who underwent chiropractic treatment. All subjects sought treatment between 11 and 51 days, with the median being 28 days. Of the 50 cases:
- 16 resolved completely
- 25 were 75% to 90% improved
- 8 were 50% to 75% improved
- 1 was 0% to 50% improved
Chiropractic can help reduce the pain, improve the shoulder’s range of motion, and speed recovery. The treatment depends on the symptoms that are present, how progressed, and how long the patient has had the state.
One common chiropractic technique used to treat frozen shoulder syndrome is the Niel Asher Technique. It involves the manipulation of the joints and muscle tissues. The chiropractor applies pressure and stretches key points to help reduce pain and resolve the condition. It can make a tremendous difference in the patient’s life.
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El Paso West Texas Chiropractic Center
907 Chelsea St. Ste. E,
El Paso, TX 79903
Phone: (915) 562-5700
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