Using a Massage Gun for better sleep with frozen shoulder

Massage can be done by self through massage guns or a lacrosse ball. Massaging the small muscles of the shoulder like the pectorals, deltoid, and trapezius, with a massage ball can be painful in the inflammatory phase of the frozen shoulder. In this case, a low-intensity massage with a flat device head can help to soothe the muscles, improve flexibility for a short time and flush out the inflammatory metabolites. 

Best sleeping position for the frozen shoulder:

Sleeping on the other side of the affected shoulder with a pillow under the armpit of the affected one. This is the easiest solution, but if you are turning frequently in sleep, the painful side gets compressed intermittently and that again disturbs the sleep.This can be managed by sleeping on a recliner or using the support of pillows on the affected side.

Using pillows and cushions to improve your sleep:

Sleeping in supine or on the straight back position: 

This position can also be supported well with the pillows under the arm.

Sleeping in a quarter-turn reclined/side-lying position by keeping the pillows under the affected side:

This position elevates the affected side up and even if you tend to turn sides, the pillows would be there to block it.

Modified Foetal Position

Most of us tend to sleep in this easy-to-go position. Sleeping on the non-affected side in this position can be well supported with the pillows between the knees, under the head, and one supporting the arms.

In case of acute pain and swelling, biofreeze spray can be the preferred modality. But for any muscle spasm and fascial tightness issue, moist heat or a heating pad before you sleep generally works the best

Sleeping Positions to avoid:

• Sleeping side lying on the aching shoulder gives the utmost pain. 
• Also sleeping on the stomach frequently puts the shoulder in an elevated position which further strains the upper trapezius and increases the shoulder pain. 

Using a TENS Machine for better sleep

TENS machine helps in numbing down the pain by blocking the thinner pain carrying neural fibres. It is not a treatment modality but definitely can help to tone down the pain just before one sleeps. 

Read more about TENS machines for frozen shoulder

Magnesium Oil:

Magnesium has been used to relieve muscle cramps and facilitate recovery of the overworked muscles.Transdermal application of magnesium oil, helps in rapid absorption and  avoids any gastrointestinal distress symptoms which come with oral ingestion.  A warm water ipsum salt bath combines the dual benefits of magnesium and heat therapy and gives full body relaxation. Magnesium supplementation can also help in easing pain, but it should be taken according to the recommended dietary allowance along with a physician consultation.

THC/Cannabis Edibles:

Depending on where you live and applicable laws, THC, the active ingredient in cannabis, can help with sleep and pain management. 

THC edibles are not approved by FDA and frequently the composition of the compounds are not stringently regulated by the sellers.THC a derivative of Cannabis is the main psychoactive substance responsible for sense of giving a high. Used as a potent sedative and pain reliever in neuropathic pain and intractable cancer, it may have a longer sleep inducing effect.It has potential side effects of varying intensities on those who consume it. The research on use of THC edibles, specific to shoulder pain is lacking and may have some benefit in chronic cases not responding to other modalities of treatment. It is very important with regards to safety  to take any psychoactive substance with a prior consultation with a doctor in accordance with the legal laws of the country.

CBD (Cannabidiol):

Cannabidiol (CBD), also a derivative of cannabis, does not contain any psychoactive substance giving a high. CBD oil, through its anti-inflammatory effects, can be used as an adjunct to improve sleep and reduce pain. Though high-level evidence lacks for the use of CBD, specific to the frozen shoulder, it can be used with precaution and as an adjunct  when available as a well-regulated product.

Melatonin:

Melatonin is a sleep inducing hormone naturally produced by the body through the pineal gland in the night when the darkness sets in. Melatonin is available as a supplement and not controlled as drug by FDA and also as a drug Ramelteon, which is basically a melatonin receptor agonist.  Both of them influence the melatonin action and help in sleeping.Melatonin has a fewer side effects like drowsiness, headaches and dizziness and are seen when it is overdosed. It can be a good supplement for short term use for sleep induction.

Medications:

Anti-inflammatory/OTC Drugs:

Naproxen and acetaminophen, the OTC drug helps in controlling inflammation and blocking the pain and also have some effect on relaxing the muscles.

Muscle relaxants:

Muscle relaxants are generally not sold over the counter and when prescribed by the physician can surely help.

Timing the medications:

These medications especially in the inflammatory phase should be taken an hour before the sleep. Medications taken too early can lose their effect in the middle of the night due to their short half-life and bring back the pain. Hence the medications need to be timed well with the sleep schedule, following with the dosage and physician’s advice.

Cortisone:

A steroid shot coupled with physiotherapy has been shown to reduce the inflammation and pain with a long term effect. It is important to avoid repetitive steroid shots in shoulder as it affects the tendon health in long term, hence the use of exercise is important to sustain the effects of the steroid and maintain the pain free range of motion. Getting a cortisone shot isn’t a decision you make before going to bed tonight, but getting a shot can help you reduce pain and inflammation for several weeks, helping you get some sleep. 

You can find out more about Cortisone Injections and Frozen Shoulder here. 

Hydrodilatation:

Hydrodilatation is the infusion of combination of saline, steroid and local anaesthetic in the shoulder joint capsule to distend it and cause micro-ruptures. It can help in giving good short term results and improving function, but long term evidence for its use is inconclusive and deficient.

Sleep Hygiene:

Good sleep hygiene which incorporates environmental and behavioral modifications helping to facilitate a deeper sleep. Like:

1. Following regular sleep timings which affect your circadian rhythms
2. Reducing the use of bright lights and screen time
3. Abstaining from caffeine use near sleep time 
4. Avoiding alcohol use to facilitate sleep as it slows down the healing
5. Managing stress well and not ruminating at night by following relaxation techniques, mindfulness, and breathwork techniques like box breathing before you sleep.
6. Avoiding noise and making use of soothing music or the podcast  of choice to fall asleep.

The post How to Sleep With a Frozen Shoulder appeared first on Siphox Health.

Here are a range of exercise videos for frozen shoulder in the thawing stage. The isometric exercises from the frozen stage should have helped you build strength in your shoulder. Now with increased range of motion as your shoulder starts to thaw, you can move to more exercises that promote range of motion recovery, strength, and mobility in your shoulder joint.

As you’re starting to see your range of motion return, check out our iOS app Reflex that allows you to accurately measure your shoulder range of motion just using the front-facing camera. It’s a great tool to see your progress and highlight which movements are returning faster and which ones you can work on to get better results. In the premium version you can get all the frozen shoulder exercise videos in the app.

Click here to download Reflex from the App Store.

Signs that frozen shoulder is starting to thaw

Entering the thawing stage is a process that happens gradually over weeks or months. You’ll be relieved to be out of the frozen stage and feel like there is hope after what may seem like an endless lifetime of reduced mobility.

Here are some signs that your frozen shoulder is thawing:

– You have more range of motion in your shoulder

– Your pain is decreasing

– You feel achy or stiff instead of sharp pain

– Your shoulder feels “looser”

As the adhesions in you shoulder start to break up, you’ll feel an increase in range of motion. This is followed by a decrease in pain as the tissue starts to heal. Some people do experience fluctuations in pain during the thawing stage.

Your frozen shoulder will likely thaw on its own given enough time, but there are some things you can do to speed up the process.

• Physical therapy: A physical therapist can help break up the adhesions in your shoulder and stretch the tissue.
• Massage: Massage can help increase blood flow and loosen the muscles around your shoulder.
• Heat: Applying heat to the area can help increase blood flow and loosen the muscles.
• Exercise: Exercising the shoulder, within the limits of your pain, can help break up the adhesions, and strengthen your muscles.

Exercises for the thawing stage are designed to increase your range of motion and strength in the shoulder. You are more likely to be injured if you have limited range of motion and limited strength in your shoulder. Increasing your strength and flexibility will also mean you can return to sports and other activities you may have had to give up during the frozen stage.

These exercises are designed to help with that.

Stabilization Flexion and Extension

Equipment Required: Resistance Band

Steps to follow:

1. Tie a band in front of you at waist level.

2. Firmly hold each end of the band with each hand.

3. Place your hands and arms in line at shoulder level with your palms facing down.

4. Move one arm over your head, keeping it straight, while the other moves close to the body downwards simultaneously.

5. Slowly return to the starting position, and repeat going the opposite way.

Scapula Retraction

Equipment Required: Mat

Steps to follow:

1. Lie on your stomach, face down with your hands on the back of your head.

2. Lift your elbows off the surface while squeezing your shoulder blades together.

3. Let your elbows down and repeat.

Supine Chest Stretch with Hands Behind Head

Equipment Required: Mat

Steps to follow:

1. Lie on your back.

2. Place your hands behind your head with your elbows bent.

3. Let your elbows drop gently towards to the floor, as low as possible.

4. Hold the position.

Shoulder Internal Rotation with Elastic

Equipment Required: Resistance Band

Steps to follow:

1. Stand and tie an elastic behind you at head level.

2. Hold the end of the elastic, bend your elbow to 90 degrees and lift your arm out to the side to 45 degrees.

3. Rotate your forearm downward, keeping your elbow bent.

4. Slowly return to the start position and repeat.

Shoulder Flexion Stretch with Swiss Ball

Equipment Required: Swiss Ball

Steps to follow:

1. Stand facing a wall and hold a ball against the wall with one hand. The arm is straight horizontally in front of you.

2. Roll the ball upward by getting closer to the wall and by raising your arm as high as possible until you feel a gentle stretch.

3. Maintain the stretch and lower your arm.

Shoulder Abduction with Elastic

Steps to follow:

1. Tie an elastic beside you at hip height and hold it firmly with one hand.

2. Straighten your arm on the side and raise it overhead as high as you can, keeping the elbow straight.

3. Lower your arm slowly and repeat.

Shoulder Flexion with resistance band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic in front of you at waist level and hold it in your hand.

2. Straighten your arm in front and raise your arm forward as high as you can, keeping it straight.

3. Lower your arm slowly and repeat.

External rotation, 90° Abduction with Resistance Band

Equipment Required: Resistance Band

Steps to follow:

1.Tie a resistance band in front of you at shoulder level.

2. Hold the end of the band, bend your elbow to 90 degrees, and lift your arm out to the side to 90 degrees.

3. Rotate your forearm upwards, keeping your elbow bent.

4. Slowly return to the initial position and repeat.

Pectoralis stretch, mid fibers – Right Shoulder Exercise (Shorts)

Equipment Required: None

Steps to follow:

1. Stand next to a wall and put your hands on the wall behind you at shoulder level, with your fingers pointing backwards.

2. Without turning the trunk, take a few small steps forward until you feel a comfortable stretch in the pectorals major.

3. Hold the stretch.

Tennis Backhand with Elastic Band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic behind you at waist level and hold it with your hand in a tennis backhand position.

2. Pull the elastic forward in a tennis backhand motion.

3. Return your arm slowly to the start position and repeat.

Tennis Forehand with Elastic Band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic behind you at waist level and hold it with your hand in a tennis forehand position.

2. Pull the elastic forward in a tennis forehand motion.

3. Return your arm slowly to the start position and repeat.

Thoracic Extension Mobility with Roller

Equipment Required: Mat and Roller

Steps to follow:

1. Place your foam roller on the floor and take a kneeling position with your wrists on the foam roller in front of you.

2. Roll the foam roller forward by lowering your chest towards the floor and stretching your spine.

Throwing Motion with Elastic Band

Equipment Required: Resistance Band

Steps to follow:

1. Tie an elastic behind your head and hold it with your hand in a “ready to throw” position.

2. Pull the elastic forward and down in a throwing motion.

3. Return your arm slowly to the start position and repeat.

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What is a TENS machine?

TENS functions with the application of a pulsed rectangular wave current via surface electrodes placed on the selected area of the skin. This current is often generated by small battery-operated machines in which circuits modify the battery’s output such that it will have a stimulatory effect on the nerves.

Usually, TENS is administered using either high- or low-frequency modes. Although many researchers employ frequencies at or above 100 Hz, high frequency can be defined as being larger than 50 Hz.

Intensity is believed to be important in maximising the effectiveness of the TENS. It should be enough to generate a strong but painless sensation and must be adjusted accordingly throughout the course of the treatment.

What does the TENs machine do?

The TENS machine works by the ‘Gate Control Theory of Pain.’ According to this theory, there exists a ‘gating’ mechanism in the spinal cord that regulates the amount of incoming painful stimuli. The pain stimuli come in through nerve fibres that have a small diameter. The sensory input of the TENS machine comes in via nerve fibres that have large diameters. Hence, it is thought that the larger nerves can block the sensations coming through the smaller ones; thereby, ‘closing the gate for pain’ and its perception. 

This may sound confusing, but humans use this mechanism to block pain unknowingly all the time. For example, rubbing your skin after hitting the edge of a table activates the large diameter nerve carrying the sensation of touch to block out the smaller pain-carrying nerve fibres. Thus, similarly, TENS electrically rubs pain away.

How does a TENS machine work?

The TENS machine can be used in the conventional mode or the acupuncture mode. During conventional TENS, low-intensity pulsed currents are administered at higher frequencies at the site of pain. This type of TENS activates large diameter non-noxious afferents (nerves with the incoming stimuli) and blocks the pain. It is more commonly used for acute episodes of pain.

The acupuncture type of TENS is less frequently used. At the site of pain, high-intensity currents are applied at lower frequencies. This is more often used in chronic cases of shoulder pain.

Now you may wonder if the ‘current’ given out by the TENS machine is anything remotely mimicking an actual electrical current that you get when you accidentally touch a wire. Well, it absolutely isn’t. The current experienced with this machine usually is a mild tingling sensation if you use conventional TENS. It can be slightly irritating in the beginning if you use acupuncture TENS as its main mechanism of action is irritation which counters the pain (counter-irritant effect). However, this does subside and does not cause prolonged discomfort.

Where to place the TENS machine pads for frozen shoulder

Before we answer the ‘where’, let’s focus on the how. How does one apply the electrodes of the TENS machine?

The first thing to do before using the machine is to test it and make sure that the machine along with its wires is intact. You can also test the current via the electrodes on the palm of your hand as a precautionary measure.

Before you do place the electrodes, ensure that you clean the skin over which you will be placing the electrodes.

Ideally, conductive rubber electrodes should be used with conductive gel to gain good skin contact. The electrodes can also be bandaged onto the skin or fixed with adhesive tape.

The electrodes should be placed over the area of pain. If it is a localised pin-point pain, both the electrodes can be placed adjacent to the area of pain. The rubber electrodes are quite malleable, so even if the rounded contour of the shoulder has pain, they can be comfortable stuck over it.

If the pain is a tingling type of pain, the electrodes can be placed in a straight line along the route of the nerve that causes the tingling.

How to use a TENS machine for frozen shoulder

There is some evidence to suggest that TENS may be helpful for frozen shoulder. In one study, TENS was found to be more effective than placebo for reducing pain and improving range of motion in people with a frozen shoulder.

Once the electrodes are stuck, the intensity must be very gradually increased. Higher intensity does not equate to better or faster healing. Thus, in order to avoid any electrical burns, optimal intensity should be chosen. After a while, you may feel that you are getting adapted to the pre-set intensity and the sensation of the machine has reduced, that is when you can gradually increase it.

There is no fixed duration for the application of the TENS machine but usually, about 20 to 25 minutes does suffice to induce pain relief. Using the TENS machine 3 times a week for around 4-5 weeks usually helps with shoulder pain. This may vary from patient to patient as all people have varied symptoms of frozen shoulder. Unlike pain-relief medications, the main advantage of a TENS machine is that it can be used multiple times a day depending on the intensity and severity of pain.

Patients with a frozen shoulder have adhesions in their shoulder joint capsule and muscular guarding due to pain. Muscular guarding is when muscles contract reflexively as a protective response to pain but remain in a contracted state, which increases the pain. 

Thus, they present with pain and a reduced range of movement of the affected shoulder joint. The TENS machine as mentioned does take care of the pain, thereby allowing the patient to move the joint more comfortably. 

Additionally, research has shown that the TENS machine can also reduce muscle hardness, thereby inducing flexibility in the muscle tissue. Therefore, after using a TENS machine, it would be beneficial to stretch the affected shoulder joint. However, this should be done gently and within the limits of pain. 

Will a TENS Machine help a frozen shoulder?

A TENS machine can provide short term and long term relief for frozen shoulder. If you are suffering from acute pain, which is typical in the freezing stage, a TENS machine electrically rubs the pain away. In the medium to long term, the TENS machine stimulates the muscles, helping to retain strength. This strength is needed as your shoulder range of motion returns.

Measure yourself

Download our app Reflex:Shoulder Mobility App to measure your range of motion and track pain over time. Reflex allows you to visualise your recovery by accurately measuring range of motion and tracking pain levels. 

Treatment will vary depending on what stage of frozen shoulder you are in. Your TENS machine can help you in all three stages of frozen shoulder. Below is an example of what your shoulder range of motion looks like in the Thawing Stage of frozen shoulder.

Click here to start plotting your frozen shoulder chart with Reflex

Best TENS Machines for Frozen Shoulder

The Best TENS machine for frozen shoulder may different for everyone. Based on budgets and availability, here are our top picks for the best TENS machine for you if you have symptoms of adhesive capsulitis.

HealthmateForever YK15AB TENS unit

Transcutaneous Electrical Nerve Stimulation unit with dedicated “Shoulder” Mode accessible by its own button

iReliev TENS + EMS Combination Unit

14 Modes including pain relief and muscle strengthening. Good all-rounder for different stages of frozen shoulder. Electrical Muscle Stimulation (EMS) also known as nueromuscular electrical stimulation (NMES) contract muscles using electric stimulation. EMS has the potential to serve as a strength training and rehab tool as well as offer post-exercise recovery benefits for athletes.

iSTIM EV-805 TENS EMS

High grade Japanese electrode pads designed for sensitive skin. High quality design, many people upgrade to this model after their entry level devices. 

TechCare Massager Touch X – TENS EMS Unit

Powerful and compact 

AUVON 4 Outputs TENS Unit EMS Muscle Stimulator Machine

Compact and powerful with a simplistic interface which means changing settings can be tiresome. Each of the 4 outputs connects to 2 pads, so total capacity is 8 pads.

Dangers and precautions of using a TENS Machine for frozen shoulder

1. Applying a high intensity of TENS alongside a high frequency for long durations can cause an electrolyte reaction under the electrodes.  
2. The TENS machine could cause a possible interference with a pacemaker’s functioning if applied too close to it and hence is inadvisable.
3. Application of TENS on an area with diminished or altered sensations should be strictly avoided.

The post Is a TENS Machine Good for Frozen Shoulder? appeared first on Siphox Health.

There are numerous strategies to help you sleep well with a frozen shoulder. Lack of sleep due to the pain of frozen shoulder is common and quite manageable. 

We all require sufficient sleep. The importance of good sleep is even greater when recovering from a frozen shoulder.

The sleep experts recommend seven to nine hours of refreshing shut eye a night.  I wasn’t getting enough. Are you?

My frozen shoulder pain kept me awake for months. I was lucky to get two or three hours. My nerves were frayed and my emotions on the brink of collapse. To survive, I had to find sleeping strategies. And I did. 

Why does Frozen Shoulder hurt worse at night?

Is It Just My Imagination?

In the daytime we are active and distracted. We forget about our pain. At night, the intense discomfort of frozen shoulder rears its ugly head. We can’t sleep. 

Scientifically speaking, during rest, blood flow to the body slows down. The kidneys become less able to remove water leading to retention and increased internal pressure. Our bodies swell. This higher pressure increases inflammation and pain. There is a legitimate reason for your night time pain. 

How Do You Stop Frozen Shoulder Pain at Night?

Gentle Stretching

• Try performing very light upper body stretches. These gentle movements help to relax stiff muscles and decrease inflammation and discomfort.

Medication

• Take advantage of pain relieving medications like Aspirin and ibuprofen. These over the counter pills ease the night time pain of frozen shoulder. Take them close to bedtime. 

Reduce Day Time Movement

• Excess movement during the day increases inflammation and pain during sleep.  Limit vigorous daily activity.  Less pain equals a restful night. 

Sleep Position

• We can’t always control our sleep position as we move unconsciously. However, we can limit movement. Place a pillow on your frozen shoulder side to prevent rolling.

• Switching to the other side of the bed can often reduce habitual night time movement and reduce discomfort.  

Frozen Shoulder Sleeping Tips

Herbal Teas

• Some great tasting teas to help with relaxation and sleep are magnolia, chamomile, lavender, valerian and passion flower tea. Find them in your local grocery or health food store. 

Pillows For Comfort

• Common household pillows are a wonderful tool to help with the night time pain of frozen shoulder. 

• Lie on your healthy side and hug a cushion or pillow. This position will support your painful arm and prevent unwanted movement. 

• Resist sleeping on your front. This causes instability in your shoulders.  Sleep on your back to keep your shoulders aligned. 

• Place a pillow under your head for more comfortable shoulders.  Add more support to your head by placing a small rolled up towel under your neck.

• A body pillow can also provide significant relief. These full length pillows are very comfortable and prevent unwanted movement.

Heat And Pain Reduction

• Heat on the shoulders at bedtime equals less pain and better sleep. Use a heating pad, hot pack, or take a hot shower.

Nutritional Supplements

• Well known natural sleep aids include melatonin, valerian and magnesium supplements.

Guided Meditation

• YouTube has a complete library of free guided sleep meditations for you to discover. Guided meditation is guaranteed to relax and support a good night’s sleep.

Sleep Hygiene

• Keep your room dark and cool, limit technology and large meals before bed and  maintain a consistent sleep schedule to ensure a good night’s sleep. 

My 5 Favorite Sleeping Strategies

• Chamomile Tea. Remember to brew for 5 to10 minutes in a covered mug.
• Lavender Oil. Apply to hands, arms and temples with a gentle massage.
• White Noise. I used a fan most nights for refreshing air circulation and to block outside distractions.
• Sleep Meditations. Find one you like on YouTube, stick in some earbuds, and in no time you will be asleep.
• Gratitude and Optimism. End each night with positive thoughts. Be thankful for how far you have come and optimistic for a good night’s sleep and healthy recovery.

Wrap Up

Treat your frozen shoulder with attention and care.  See a physiotherapist for treatment, support, stretches, pain relief, mobility assessment, and sleeping strategies. Experiment with  sleeping positions and pillows. Try guided sleep meditations. Good nutrition is also important.

Check this out: https://reflexhealth.co/mobility/how-to-reduce-pain-and-inflammation-with-diet/

Final Thoughts

Working through the pain and discomfort of frozen shoulder is physically and mentally exhausting. What works well one week to reduce frozen shoulder pain may not work the next. Be proactive. Do some research. Most importantly, make sure to take advantage of all of the available sleep techniques to ensure a rejuvenating sleep and healthy recovery from your frozen shoulder. 

Image 1 – Courtesy of UnSplash  kinga-cichewicz 

Image 2 – Courtesy of UnSplash  khadeeja-yasser-9j 

Image 3 – Courtesy of UnSplash  manki-kim L82-KK

Also published at:https://1birthdayfun.medium.com/

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Frozen shoulder occurs more commonly in women than in men, tends to present in middle age, occurs in 1 in 5 diabetics, and can sometimes occur in both shoulders.

The good news is that the condition generally resolves or “thaws” spontaneously. The bad news is that this recovery can take from 6 months to more than 2 years. Furthermore, some patients report that their shoulder never recovers fully.

Fortunately, several treatment options are available that may ease the symptoms of this debilitating condition and even hasten the recovery to a full, pain-free range of motion. 

In this article, we’ll explore the pros and cons of the most common treatment options ranked from least invasive to most invasive.

Physiotherapy

For most patients, enrolling in a physical therapy program is the key to recovery and should be considered the backbone of frozen shoulder treatment.

Patient education is one of the most vital components of the physiotherapist’s role. By gaining an understanding of their own condition and being made aware of their own progress, patients can manage their expectations, reduce their frustration and be more compliant with their home exercise programmes.

Physiotherapists will invariably employ some manual muscle release techniques, passive and active mobilisations and various stretches. Depending on the stage of the condition, the physiotherapist may choose to include dry needling, TENS machines or kinesiotherapy techniques.

Hot and cold therapy

The joint is inflamed and painful during the initial “freezing stage” of frozen shoulder.

At this point, applying a heat pack might well make things worse. Choose a cold compress or ice pack instead to ease the pain. 

In the later adhesive or “thawing” stages, heat packs can be very effective when used before a stretching or home exercise session to promote an increased range of motion.

Topical creams and lotions

Various warming and cooling gels are available over the counter. Although these ointments might feel pleasant or tingly when applied, they will not impart any significant benefit.

In the initial painful phase, gels and patches containing non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac may help to ease pain and inflammation.

Oral medication

Doctors often prescribe non-steroidal anti-inflammatory drugs to Frozen Shoulder patients. However, there is no high-level evidence that confirms their effectiveness. Nevertheless, many patients report they do provide relief during painful phases.

Oral corticosteroids are also prescribed to patients with frozen shoulder. The drugs mimic cortisol, a hormone produced by the body to temper an overreactive immune response. Corticosteroids rapidly reduce inflammation either directly or throughout the body. Many patients report some improvement in function after their use.

Long term oral steroid use does run the risk of significant side effects and so these drugs should be used in short bursts, if at all.

Corticosteroid injections

By injecting a corticosteroid medication directly into the shoulder joint, the powerful anti-inflammatory effects of the steroid can be concentrated where they are needed most. If performed early in the disease process the degree of inflammation within the joint can be lessened leading to less severe fibrosis and fewer adhesions forming. For this reason, corticosteroid injections are considered more effective in the painful and freezing stage of the condition. The corticosteroid is almost always mixed with a local anaesthetic agent that will also reduce pain and aid with improving the motor control of the shoulder complex.

Success rates range from 44 to 80% and many patients report rapid pain relief and improved function within the first few weeks of the injection. The injection may be given at the sub-acromial site or as an intra-articular injection but a recent study suggested that combining both sites may be the most effective. Corticosteroid injection should be considered a first-line treatment for patients with pain as their predominant complaint in the early stages of frozen shoulder. By combining a corticosteroid injection with ongoing physiotherapy, patients may give themselves the best chance at a rapid recovery without the need for surgery.

Manipulation under anaesthesia (MUA)

This involves going to an operating theatre and undergoing a general or regional anaesthetic. Once anaesthetised, the surgeon forcefully moves the shoulder in all planes in an attempt to stretch and disrupt the capsule to regain range of motion. It is not without risk of complications such as dislocation or fractures or even nerve injuries.

MUA should be considered a last resort and reserved for patients who are resistant to physical therapy. After manipulation, an extensive post-manipulation programme is necessary to preserve any range of motion gained.

Hydrodilatation

Also known as distension arthrography, hydrodilatation has emerged as a potential non-surgical option in the management of frozen shoulder. It involves the injection of a large volume of fluid (usually containing some steroid and local anaesthetic) into the shoulder joint under x-ray guidance. The goal is to stretch and expand the joint capsule like a water balloon.

There is no high-level evidence to support the technique yet but some studies have shown that it can provide short-term pain relief and improved function for up to 3 months.

Arthroscopic capsular release

Open shoulder surgery is almost never performed for frozen shoulder anymore. Arthroscopic surgery or so-called “key-hole surgery” however, is a reliable and effective method for restoring range of motion in non-responsive patients. It allows a controlled release of tight capsular structures under direct vision and avoids many of the side effects associated with MUA (although nerve injuries remain a concern).

Arthroscopic treatment should be considered in patients unresponsive to at least 6 months of good conservative treatment.

Conclusion

When it comes to curing frozen shoulder quickly, we may need to redefine what we mean by “quickly”. Frozen shoulder is a condition that can grumble on for years and expectations of a “quick-fix” are unrealistic. That said, there are many treatment options available that can accelerate the journey to healing. 

Early diagnosis is vital so that a corticosteroid injection has a chance to extinguish the inflammatory process. Ongoing physiotherapy can then restore any lost range of motion. 

All hope is not lost for patients who fail to respond to conservative measures – more invasive treatments including MUA, hydrodilatation or arthroscopy can be effective at treating this frustrating condition.

By Dr. Jarrad Van Zuydam, Sports Physician

Take control of your shoulder recovery with Siphox Health

With Siphox Health monitor your shoulder range of motion and shoulder pain over time. Users say “It would be like going on a diet without tracking your weight loss.” Take control today by downloading the Siphox Health App.

The post How to Cure Frozen Shoulder Quickly appeared first on Siphox Health.

A diagnosis of frozen shoulder is daunting. This painful condition progressively disables upper body mobility. Daily activities become onerous. You want to heal. The advice of professionals is vital to your health.

Follow the do’s and don’ts to ensure a full recovery.

“The course of frozen shoulder can run from one to three years.” You are in constant pain.  How will you manage? 

The do’s and don’ts of frozen shoulder will help to fortify your success. 

These healing tools include:  early intervention, exercise,  positive mind set, pain management and support, sleep, patience, nutrition, gratitude and resilience. 

Armed with these amazing techniques, you can’t help but succeed.  

Today you can’t reach the top shelf in your kitchen!

It is time to learn all you can about the do’s and don’ts of frozen shoulder.

You make an appointment with your doctor.  He confirms a diagnosis of frozen shoulder and refers you for physiotherapy. 

What now?

16 Do’s and Don’ts of Frozen Shoulder

Early Intervention and Exercise

DON’T wait until you are desperate for help. Frozen shoulder can affect your professional and personal life. Make an appointment to see your doctor. Early intervention is key to a successful recovery. I waited too long. I thought I had pulled a muscle.

DO listen to the professionals. Physiotherapy treatments, guidelines and support are paramount for recovery.  Attend appointments on a regular basis, and commit to performing exercises and stretches as directed. I was diligent. I attended as many sessions as possible. The treatment was invaluable. 

DON’T over do it. A prognosis of a one to three year recovery time is discouraging. It is human nature to want to speed up healing by doing too much too soon. Listen to your physiotherapist. I was frustrated and ended up hurting myself. Heed the advice of professionals. 

DO keep active. Don’t let the pain of frozen shoulder discourage you from moving. The discomfort can be excruciating. However, restricting mobility will increase stiffness, recovery time, and amplify pain. Make it a daily practice to keep active. I made a commitment to walk at least ten minutes a day.minutes. This simple activity was a life saver. It improved my mood, pain and sleep. 

Positive Attitude and Pain Management

DON’T blame yourself.  Frozen shoulder is not your fault. Millions of people are diagnosed every year. Sometimes there are pre-existing health conditions, often there are not. It affects more women than men, and generally individuals between forty and sixty. I berated myself for ignoring the pain. This didn’t help. 

DO nurture a positive mindset. With hard work, a positive attitude, and perseverance, the majority of individuals with frozen shoulder will recover. Re-frame. Make it a habit to turn negative thoughts into positive. I learned this technique has tremendous healing power. 

“You either get better or bitter. It’s that simple. You either take what has been dealt to you and allow it to make you a better person, or you allow it to tear you down. The choice does not belong to fate, it belongs to you.

Josh Shipp

DON’T be a hero. Seek support, guidance, treatment and pain management. Confide in friends, family members and medical professionals.  You don’t have to go this alone. I started journaling. Recording my thoughts and feelings reduced my anxiety. Give it a try.

DO take advantage of suggestions for pain control. Ice packs help to reduce inflammation while hot packs promote circulation. Over-the-counter medications also help to reduce inflammation, pain and promote mobility.  When you lessen pain, you provide your brain and body with a much needed break. Take advantage of available medication. Ibuprofen “took the edge off” and helped me sleep. 

Sleep and Patience

DON’T put pressure on your arm while sleeping. This leads to compression, inflammation and pain. I placed cushions on either side of my body to keep from rolling onto my painful shoulder. 

DO try to sleep on your back. This will reduce pain and assist with a restful night of sleep. Try the side pillows. 

DON’T expect a speedy recovery. This is unrealistic and will breed frustration. A frozen shoulder can take many months to years to fully heal. Practice patience. This was a hard one for me. I was so tired of the discomfort and restrictions. 

DO take the time to learn about frozen shoulder. Knowledge is power. I read a lot of material about frozen shoulder. 

Nutrition and Gratitude

DON’T forget about good nutrition. I was exhausted and in pain. I craved carbohydrates and sugar. 

DO make it a practice to reduce sugar and refined carbohydrates, and increase fresh vegetables, fruits, lean meats and legumes. I substituted lemon water for soda, fresh fruit for sweet dessert, and occasionally, fish for red meat. I felt better and lost some weight. 

DON’T obsess about the negative. Count your blessings and express gratitude. Gratitude is a tremendously healing emotion. The practice of gratitude increases the feel good chemical dopamine. The more gratitude, the more dopamine. I was so thankful for the support I received.

DO remain optimistic about your recovery. Most people who have experienced frozen shoulder regain full mobility. Believe you will heal. I did. You will too!

Resilience

DO remember and DON’T forget:

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Article also published at: [email protected]

Take control of your shoulder recovery with Siphox Health

With Siphox Health monitor your shoulder range of motion and shoulder pain over time. Users say “It would be like going on a diet without tracking your weight loss.” Take control today by downloading the Siphox Health App.

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What is a Frozen Shoulder?

Medically, Frozen shoulder is known as adhesive capsulitis. The shoulder joint is a ball and socket joint, which means that the round head of your upper arm bone (humerus) fits into a shallow socket in your shoulder blade (scapula).

Frozen shoulder occurs when the connective tissue around the shoulder joint becomes stiff and inflamed. This can make it difficult to move your arm. Adhesive capsulitis often develops slowly, and symptoms can worsen over time.

The characteristic feature of frozen shoulder is complete loss of External Rotation.

The Three Stages of Frozen shoulder:

Freezing stage:

Stage I: This is the first stage of frozen shoulder and is also known as the painful phase. You may feel pain when you move your arm, and your range of motion (ROM) will start to decrease. Typically the shoulder pain is worse at night. The onset of pain and reduction of ROM in this stage is sometimes confused with Rotator Cuff tendinopathy. However, Rotator Cuff tendinopathy cases do not have a gradual decrease in Range of Motion, whereas adhesive capsulitis will have week-on-week reduction of shoulder range of motion.

Duration: 2-9 months

Frozen stage:

Stage II: This is the second stage of frozen shoulder, characterised by “pain and stiffness” in varying proportions. Your pain may decrease during this stage, but your range of motion will continue to decrease. In the early stages of Stage 2 of Frozen shoulder, you may primarily still be experiencing pain. The latter part of the frozen stage is characterised with more stiffness than pain.

Duration: 4-12 months

Thawing stage:

Stage III: This is the final stage of frozen shoulder. Your range of motion will start to improve, but you may still have some pain and stiffness. The gradual return of range of motion is due to reducing inflammation and fibrosis in the shoulder joint.

Duration: 12-36 months

Reference: Idiopathic Frozen Shoulder

How Long Does Frozen Shoulder Last?

Frozen shoulder typically lasts anywhere from six months to two years. However, there are some patients who show symptoms for up to four years.

Can frozen shoulder come back?

Recurrence is uncommon, however the other shoulder can become affected in up to 17% of patients within 5 years.

Most patients are able to recover their full range of motion, however some patients have reported reduced range of motion more than a decade after they had a frozen shoulder. Reduced range of motion not only increases risk of injuring your shoulder, it also impacts quality of life by restricting activities that someone used to do with full range of motion of their shoulder.

What does frozen shoulder feel like?

Frozen shoulder can cause a dull, aching pain that gets worse with movement. You may also feel stiffness and decreased range of motion in the affected shoulder. The symptoms of frozen shoulder typically develop slowly over time and worsen over the course of several months.

What is frozen shoulder pain like?

The freezing stage is associated with the highest degree of pain, lasting anywhere from six weeks to one year or more.

What Causes Frozen Shoulder?

There are two main types of frozen shoulder: primary and secondary. In both cases, frozen shoulder is caused by contracture of the glenohumeral joint; ie the tightening of the muscles, tendons, skin, and nearby tissues that causes the joints to shorten and become very stiff. Fibrous tissues also develop in the shoulder joint, creating a meshed web around the glenohumeral joint.

However the exact causes for the above mechanisms are still unclear.

Primary Frozen Shoulder

Primary frozen shoulder happens for unknown reasons and often spontaneously without an obvious preceding event . It is more common in women and people over the age of 40.

The shoulder capsule becomes inflamed. Specifically, the synovium is the connective tissue that lines the inside of the shoulder capsule. Inflammation of the synovium is called synovitis, which is often the first cause of primary adhesive capsulitis.

As well as synovitis, Primary Frozen Shoulder also shows fibrosis of the shoulder joint capsule, which the is development of fibrous connective tissues in response to injury or damage.

The main cause of primary frozen shoulder is unknown, however the initial inflammation is associated with increased collagen (the main protein building blocks in animal cells) and the presence of cytokines, which are small proteins that control the activity of other immune cells. This suggests that frozen shoulder is in part caused by auto-immune functions in the body.

Secondary Frozen Shoulder

Secondary frozen shoulder happens after a shoulder injury from over-use or from trauma of the shoulder. Damage and immobility of the shoulder can cause fibrosis and inflammation of the shoulder capsule.

What is the main cause of frozen shoulder?

You can get frozen shoulder from trauma or injury of the shoulder, or frozen shoulder can be idiopathic, arising spontaneously.

The prevalence is about 3-5% of the general population. The peak age of onset is 40-60 years of age, and women are slightly more likely to get it.

How do you get frozen shoulder?

Frozen shoulder has a prevalence of up to 20% for people with diabetes, much higher than the average. Therefore people with diabetes are more likely to get frozen shoulder.

Other co-morbid conditions for adhesive capsulitis include hyperthyroidism, hypothyroidism, hypoadrenalism, Parkinson’s disease, cardiac disease, pulmonary disease, stroke, and even unrelated surgical procedures such as cardiac surgery, cardiac catheterization, neurosurgery, and radical neck dissection.

How to Cure Frozen Shoulder

There is no cure for frozen shoulder. In most cases, the condition will simply go away by itself. However, depending on the severity of the condition and if the patient has had huge changes to their life, a range of treatments are available.

What is the best treatment for frozen shoulder?

The best treatment of frozen shoulder depends on what stage you are in, as each stage has different symptoms and pathologies.

Frozen Shoulder Treatment During Freezing Stage

The freezing stage is characterised by widespread inflammation in the joint capsule, synovium, and ligaments causing pain as the main symptom.

Treatment during the freezing stage should be to minimise pain so that you can continue with daily activities with as little discomfort as possible.

Rest and Ice

The easiest step is to rest the shoulder and apply ice packs. Application of ice can bring immediate relief to pain caused by swelling (inflammation).

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs such as ibuprofen or naproxen to help reduce pain and inflammation. NSAIDs work by blocking the production of prostaglandins, which are hormones that are involved in the process of inflammation at sites of damaged tissue in the body.

Steroids (local or oral)

Corticosteroid injections or oral steroids can be used to directly reduce inflammation in the shoulder joint. These are typically only used if NSAIDs have not worked, as they come with a range of potential side effects. Short to mid-term steroid use has shown to be effective in managing symptoms of adhesive capsulitis, however the effects were not maintained 6 weeks after stopping it.

Corticosteroids are drugs that mimic cortisol, a hormone produced by the body to temper an overreactive immune response. Corticosteroids rapidly reduce inflammation either directly or throughout the body. These can be administered orally or directly by a needle into the shoulder.

Locally injected steroids have been proven to be more effective than oral steroids for reducing pain.

Steroids are most effective during early stages of frozen shoulder- from the freezing stage to beginning part of frozen stage to control inflammation and reduce pain.

Pain-relieving Physiotherapy

The goal of pain relieving physiotherapy treatments is to reduce your discomfort and enable you can do daily activities. Pain relief may come from electrotherapy.

Electrotherapy reduces pain and increases function by increasing energy at the site of injury. Modalities include Laser, short wave diathermy and ultrasound.

Pain-relieving Physiotherapy has the best outcomes when used in conjunction with NSAIDs and/or steroids, rather than PT alone.

During periods with high pain, it is important not to do do any strenuous PT as this can increase inflammation and pain.

Remember that the goal of treatment during the freezing stage of frozen shoulder is to reduce pain, and ease normal functions of daily living, including getting better sleep.

Frozen Shoulder Treatment During Frozen Stage

Frozen stage: The loss of range of motion (ROM) is profound in this stage due to fibrosis in the joint capsule and surrounding ligaments. Treatment strategies should primarily aim towards gradually increasing and regaining range of motion with a structured mobilisation Physiotherapy program.

Hydrodilatation

Hydrodilatation (HD), also known as Distension Arthrography, can be used early in the frozen stage to break down the fibrosis structures and accelerate regaining range of motion. This treatment is the injection of saline, steroid, and local anaesthetic into the glenohumeral joint. However, not much difference is shown compared to a steroid injection into the glenohumeral joint.

NSAIDs can also be used to keep pain at bay during the frozen stage.

This is best treatment for most people with frozen shoulder. However, if mobilisation physiotherapy and Hydrodilatation has not worked for weeks to months for reducing pain and regaining range of motion, you may resort to Manipulation Under Anaesthetic (MUA) or Arthroscopic Capsular Release (ACR) treatment, both of which are discussed below.

Note that MUA and ACR are very invasive. Before making this decision, ensure that you have worked consistently with your physiotherapist and have been monitoring your shoulder range of motion. Regaining range of motion can be slow, however most people see progress over a series of weeks and months.

How to monitor shoulder range of motion?

You can use an app such as Siphox Health to measure your shoulder range of motion and track pain. Knowing what stage of frozen shoulder you are in is key for ensuring that you take the best course of action for your condition.

The Siphox Health App is easy to use and provides accurate range of motion measurements for your shoulder. You can simply download the app from the AppStore, create an account you will be guided through the exercises and view your measured ROM on the screen. It uses your front-facing camera and you can do a full assessment in 4 minutes from home.

Frozen Shoulder Treatment During Thawing Phase

In the final phase of frozen shoulder, pain will be minimal or non-existent with gradual increase of range of motion over the last few weeks. At this stage, surgery treatments are no longer needed.

Physiotherapy is the main treatment- from mobilisation to increasing strength in your shoulder.

How to fix frozen shoulder

If the above conservative treatments of frozen shoulder, the following operative procedures are used to fix the shoulders. By breaking or removing the connective tissues in the shoulder joint, range of motion is restored.

Surgical Treatments

In severe cases of Frozen Shoulder, surgery may be necessary to release the tightened tissue around the shoulder joint. Surgery should only be considered if after 6-9 months of the conservative treatment above has not been successful in relieving the symptoms.

The main surgery options for primary frozen shoulder are Manipulation Under Anaesthesia (MUA) and Arthroscopic Capsular Release (ACR).

Manipulation Under Anaesthesia (MUA)

MUA for frozen shoulder is a method of moving the arm through ranges of motion under anaesthesia. The fibrous shoulder capsule prevents ROM of the shoulder, and forcibly moving the shoulder joint through the range of motion breaks these fibres.

MUA is an effective way of treating primary adhesive capsulitis in the frozen stage (Stage 2), where external rotation is less than 50% of the “good arm”. MUA should not be performed for patients with secondary frozen shoulder. If you have secondary frozen shoulder, you should opt for Arthroscopic Capsular Release.

How Manipulation Under Anaesthesia is Performed

MUA does not require cutting into the body or other specialist equipment. Under anaesthesia, the patient’s shoulder is gently moved through the normal ranges of motion of the shoulder:

• Flexion
• Abduction
• Internal & external rotation, with the arm at 90º abduction
• External rotation with arm close to the chest
• Cross-body adduction

These movements will break the fibrous web that has grown in the shoulder complex. The breaking of fibres can often be felt or heard by the surgeons. During the procedure, the surgeons will not push against and excessive resistance from the frozen shoulder. Instead, they will move to the next exercise in the sequence. The movements are then repeated to ensure all ranges of motion has been acquired.

Often, surgeons will inject local anaesthetic and/or steroid injections, to reduce post-operative pain. However there is not much evidence to show if this is necessary.

MUA has shown to be effective with improvements lasting long term for the patients. The timing of the treatment does not impact results, so you don’t need to rush to make a decision to get it done.

What are the risks of Manipulation Under Anaesthesia?

The data for MUA shows a complication rate of 0.4%. The range of motion of flexion and abduction respond very well to MUA, however there may still be reduced ROM in external and internal rotation. The lack of recovered ROM is due to surgeons being careful when performing external internal rotation movements.

During the procedure, the surgeons will support your scapula and shoulder joint appropriately for each movement.

Although rare, some complications have been reported for MUA, typically when the surgeons push to reach terminal range of motion.

MUA for patients with diabetes

Patients with Diabetes achieve the same benefits of regaining shoulder range of motion after MUA. However 36% of diabetic patients required a repeat procedure, compared to 15% of non-diabetic patients.

Arthroscopic Capsular Release (ACR)

Arthroscopic Capsular Release has become the preferred treatment for Frozen Shoulder compared to MUA. However there is no strong evidence to suggest that it is better.

“Arthroscopy” is the procedure of inserting a narrow tube connected to a fibre optic cable into the shoulder joint.

What is Arthroscopic Capsular Release (ACR)?

The capsule is a layer of tissue that surrounds the shoulder joint. The Frozen Shoulder will cause the shoulder capsule to thicken and contract, which then limits movement at the shoulder.

Arthroscopic Capsular Release involves cutting some of the fibrous tissue around the capsule to allow for more movement in your shoulder. This is done by making several small incisions (portals) around the shoulder. Fibre-optic camera is inserted into one portal and surgical instruments are inserted into other portals. The surgeon will look at the shoulder through the camera while removing tissue to release the capsule. A radio frequency device (RFD) is used to remove the tissues using heat. The tissues thickness can be 4 mm or up to 7 mm thick.

Arthroscopic Capsular Release (Video)

The Arthroscope is typically 2.9 mm wide and inserted through the posterior portal, which is located 2 cm below and 2 cm towards the centre of your body from the acromion. You can feel your acromion with your opposite hand reaching across your chest to your shoulder, it is the bony tip of your shoulder blade (scapula). Reaching a finger over the acromion, you can feel where the posterior portal would be.

Arthroscopic Capsular Release is done as an outpatient procedure, which means you will not need to stay overnight in the hospital. The procedure typically takes 30-60 minutes. The surgeon will work quickly to reduce inflammation of the shoulder joint.

MUA after ACR

After the procedure, the surgeon will perform Manipulation Under Anaesthetic of the shoulder, as described above. This ensures that full range of motion of the shoulder has been regained

Physiotherapy after Arthroscopic Capsular Release

Aggressive physiotherapy is recommended after ACR, nay, necessary, with no restrictions on range of movement of the shoulder. Before signing up for ACR, you must buy into the treatment. The treatment will only be effective if it is followed suitable physiotherapy as prescribed by your medical professionals.

Arthroscopic Capsular Release for Diabetics

Patients with Diabetes have reported clear benefits of ACR, however there are reports of reduced ROM and higher pain compared to non-diabetic patients after ACR.

Post-Operation Care after MUA or ACR

Suitable pain control is required for 2-3 weeks using NSAIDs and Ice packs is necessary after ACR and MUA treatments.

Physiotherapy after Surgery

A structured Physiotherapy programme is essential for the next 4-6 months after surgery. The goal of physiotherapy is to maintain the regained range of motion from the procedures.

The physiotherapy programme should consist of early passive and active-assisted Range of Motion exercises with scapula stabilisation in the first stage.

This is followed by strengthening exercises for rotator cuff, scapular muscles, and core rehabilitation.

MUA vs. ACR

Before starting an invasive procedure to cure frozen shoulder, patients must follow the conservative treatments effectively for 6-9 months. Only if these treatments have not produced effective results, then invasive procedures can be explored.

There is no evidence proving the superiority of ACR or MUA over the other. MUA is the most cost-effective way to treating severe cases of frozen shoulder. A study has shown that complication rates for both MUA and ACR are 0.05%.

Conclusion

Frozen shoulder is a debilitating condition that can be treated with various methods, both conservative and invasive. Conservative treatments include managing pain and following advised physiotherapy programmes best suited to the current stage of frozen shoulder.

Arthroscopic Capsular Release (ACR) and Manipulation Under Anaesthetic (MUA) are two of the most invasive procedures for frozen shoulder, but should only be considered after 6-9 months after the onset of adhesive capsulitis and enthusiastic participation in conservative treatments.

Take control of your shoulder recovery with Siphox Health

With Siphox Health monitor your shoulder range of motion and shoulder pain over time. Users say “It would be like going on a diet without tracking your weight loss.” Take control today by downloading the Siphox Health App.

The post What is Frozen Shoulder? appeared first on Siphox Health.

Thyroid Disease and Frozen Shoulder

Frozen shoulder is more common in people with thyroid problems and other endocrine problems. The thyroid is a gland that produces hormones that regulate the body’s metabolism. When the thyroid is not functioning properly, it can cause a number of different health problems.

Thyroid disease can cause inflammation in the shoulder capsule, causing it to contract and form scar tissue.

Diabetes and Frozen Shoulder

Frozen shoulder is more common in people with diabetes. Diabetes is a condition that occurs when the body does not produce enough insulin or the body cannot use insulin properly. Insulin is a hormone that helps the body to regulate blood sugar levels. When blood sugar levels are high, it can damage the nerves and blood vessels. This can lead to a build-up of scar tissue around the shoulder joint, which can cause frozen shoulder.

Previous Shoulder Injury

Frozen shoulder is more common in people who have had a previous shoulder injury. Shoulder injuries can range from minor to severe. A minor shoulder injury, such as a sprain or strain, can heal on its own with time. However, a more severe shoulder injury, such as a dislocation or fracture, may require surgery to repair. After a shoulder injury, it is common for the joint to become stiff and painful. This can lead to the development of frozen shoulder.

Stress and a Dysregulated Central Nervous System

Many patients with Frozen Shoulder have reported that their frozen shoulder symptoms developed during a stressful period in their lives. Perceived stress impacts many functions of the neuroendocrine system. The neuroendocrine system is the interaction between the Central Nervous System and the endocrine systems in control of homeostasis, which is the maintenance of a stable internal environment.

Prolonged periods of stress, anxiety, and other emotions such as fear impacts many functions of the neuroendocrine system through experience-dependent plasticity, affecting the way the brain continues to grow and develop. As with Thyroid Disease, hormone imbalance can cause inflammation in the shoulder joint, causing frozen shoulder and other undiagnosed health issues.

Dysregulated Nervous Systems can be fixed by sleeping better, exercising regularly, grounding oneself emotionally and other holistic practices.

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Individuals suffering from frozen shoulder are no stranger to chronic pain, restricted mobility, and sleepless nights. The stigma associated with frozen shoulder contributes to the misery and  despair. 

If you suffer from chronic pain you are not alone.  Millions of people across the globe can relate.  This type of pain is especially difficult to endure. It persists because the nervous system continues to fire and send messages to the brain. 

The statistics for this debilitating condition are sobering:

• Chronic pain can last for six months or more
• There are four main types of chronic pain
• Your chances of experiencing chronic pain increase with age
• Most adults need medical attention for chronic pain
• 10% of people in the world experience chronic pain
• Chronic pain victims get 42 less minutes of sleep a day  
• Overdose kills more Americans than guns

Reference from Geek Health Journal

5 Types of Pain With Frozen Shoulder

Shoulder Pain

Pain is the best known symptom of frozen shoulder. The discomfort resides in the nerves of the shoulder region and musculoskeletal tissues. These two can become painfully intertwined. 

The freezing stage is associated with the highest degree of pain, lasting anywhere from six weeks to one year or more.

Frozen shoulder pain begins as a dull ache with increasing intensity over time. I felt like my shoulder joint was being jabbed with a hot metal poker. It “was on fire.” Pain radiated down my arm. Reaching up or sideways was excruciating. Dressing was next to impossible. This type of discomfort was new and took my breath away. 

Neck Pain

Because the shoulder and neck are closely connected, neck pain often accompanies shoulder discomfort. Reduced mobility exacerbates the pain.

The pain that ran from the base of my neck to my shoulder joint and down my arm was intense. I was shocked by what felt like an electrical current zapping me with intense discomfort. 

Night Pain

Most patients experience more pain at night from increased inflammation and compressed nerves because of pressure on the arm during rest. 

Night pain is particularly distressing. Insufficient sleep hinders healing. Our bodies marinating in anxiety can’t be good for us. I would wake with a gasp to an arm screaming with rage. Ice packs provided temporary relief. 

Stiffness

Reduced mobility and increased stiffness intensify in the frozen stage. Routine activities are difficult. The shoulder becomes frozen in a capsule of tight connective tissue.

In the freezing stage, pain was concentrated in the shoulder joint and neck. Discomfort has been noted to diminish in the frozen stage, but not always. The left side of my upper body felt like a solid block of cement. Any attempt to lift or rotate my arm left me unprotected and vulnerable to an assault of deep raw pain. 

Decreased Mobility

Any movements of the arm can become excruciating.  Lack of mobility causes additional scar tissue. The shoulder is literally frozen in place.  

Fear of pain becomes as debilitating as the force of pain itself. You are afraid to move. 

Many undergo surgery to break up the unrelenting grip. I would inadvertently bang or jostle my arm. The pain was intense and almost surreal. It felt like it was happening to someone else. The angry red scar tissue did not wish to be disturbed. 

ZINGERS

Zingers are like bee stings or zaps, and common with frozen shoulder. I would describe a zinger as a burning, shocking, squeezing, or cold prickly sensation that comes out of the blue. Ice packs help with zingers.

My Experience of What Frozen Shoulder Pain Is Like

After two plus years, I felt isolated and misunderstood. Others doubted my suffering. Many presumed I was weak. 

Medical professionals were quick to dismiss frozen shoulder as a mysterious affliction that disappears with time. I was slipping deeper into a state of depression and disbelief.  What was happening?  I experienced lightning bolt pain across my upper back, down my arm, and into my fingers. It was a bizarre mix of life changing symptoms. I was desperate for relief.

The pain and disability of frozen shoulder may affect job security, finances, emotional, mental and physical health, self-confidence and social activity.

Many experiencing the pain of frozen shoulder are set adrift in a sea of uncertainty and dysfunction, without sufficient support, or effective strategies for pain management. 

ADVICE

My pain was unrelenting. I couldn’t sleep, dress, shower, wash, cook, clean, or drive my car. I did, however, receive a great deal of advice.

“Wrap a towel around the shower rod and use it to stretch your bad side.”  I remember clenching my teeth to muffle a scream. It was sheer agony. A routine dental check revealed a mysteriously cracked molar. I declined an explanation.

I slipped on our basement stairs. I grabbed the hand rail with my bad arm to prevent a complete tumble. The pain stole my breath. “Well it is a good thing really, you probably tore some adhesions and saved yourself from surgery.” Really?

Treatments for Frozen Shoulder:

Physiotherapy

It is alway wise to seek professional help. Qualified personnel will work on stretches, exercise, and assist with pain relief.  A physiotherapist will gradually increase the range of motion threshold to ensure optimum healing. Balancing exercises are also important to reduce injury to other parts of the body. 

Pain Relief

Non-prescription medications like ibuprofen and aspirin help to reduce inflammation and encourage mobility. Maintaining movement will assist in a positive recovery.

Corticosteroid Injections

A needle with medication is inserted into the shoulder joint. This assists in reducing pain and inflammation for several weeks to months. A commitment to consistent exercise will help to continue to break up scar tissue and provide relief from stiffness.

Surgery

When other treatment options have been unsuccessful, surgery may be recommended. Scar tissue is removed from inside the joint of the shoulder. Post-surgery physiotherapy is recommended to ensure the restoration of a full range of motion. 

Final Thoughts

You are not alone. Frozen shoulder or adhesive capsulitis is not uncommon. Statistics suggest that a staggering five to twenty percent of the population will suffer from the pain and dysfunction of a frozen shoulder. 

A frozen shoulder can take from one to three years to heal. Because of the significant daily pain and dysfunction, anyone experiencing shoulder discomfort is advised to seek a medical assessment promptly. This will ensure adequate support, professional treatment, and much needed pain management. 

Talk to your friends, family members, and your doctor about your feelings. Start a journal to record your thoughts and progress. There are many frozen shoulder support groups online, and helpful information. Keep moving forward. 

You have got this!

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