Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning to review a disorder known as Adhesive Capsulitis or better known as Frozen Shoulder. This is a very common disorder that I see on a regular basis in my office, and I would say that this is one of my favorite shoulder disorders to treat.
In the image above by MMG 2001, we are able to see the changes the occur with the joint capsule with Frozen Shoulder. The cause of Frozen Shoulder is currently unknown, but the most accepted theory is that adhesions develop within the capsule of the shoulder. However, this is not always seen at surgery. Furthermore, the patient often respond favorably to stretching techniques that place very little stretch on the capsule. There are certain groups of individuals that are predisposed to Frozen Shoulder including those with diabetes, hyperthyroidism, or chronic obstructive or other lung disease, and those who have had a heart attack. It has been proven, contrary to common logic, this disorder is not due to immobilization of the shoulder. This process begins as an inflammatory process that progresses to fibrosis. The three phases include the following:
- an acute inflammatory phase that causes a presentation that overlaps with some other condition
- a stiffening phase
- a thawing phase where some of the range of motion returns
These patients come into my office with varying symptoms based on the their current phase. These patients are usually over the age of 40. In the acute phase they complain of moderate to sever pain that limits all shoulder movement. Usually they cannot recall any specific event that lead to the pain. The pain interrupts their sleep, and in most cases leads these individuals to seek prescription pain medication. In the stiffening phase these individuals tell of a history consistent with the acute phase ; however, now the pain is substantially less, but the range of motion in the shoulder is severely limited. In the final phase there is an increase in the range of motion, but the range is still very limited.
Management for this condition is not the most comfortable thing to go through. Soft-tissue therapies including Active Release Technique (ART) and Graston Technique are used to increase the range of motion in the shoulder by attempting to break the fibrous adhesions that have developed with the shoulder musculature and joint capsule. Range of motion and stretching exercises are implemented as soon as possible. If these conservative measures are not showing improvement after a couple of month, more aggressive procedures are utilized such as Manipulation Under Anesthesia.
If you are struggling with Shoulder Pain or Frozen Shoulder, call my office today (480) 366-4041. We can Help!