ORTHOPEDICS

Frozen shoulder

The symptomatology of patients with frozen shoulder is dominated by pain and extremely limited passive and active mobility in the shoulder joint.

WHAT IS A FROZEN SHOULDER?


It is a syndrome of unclear etiology, although there is evidence that a frozen shoulder is somewhat more common in diabetics. Pathophysiologically, the capsule of the shoulder joint is markedly thickened, fibrously altered, infiltrated with vascular tissue, and numerous adhesions can be seen on its surface, which is why the disease is often called adhesive capsulitis. However, it is important to note that these are reversible changes in the joint that can be completely eliminated with proper therapy, and the patient recovers completely.



The articular capsule of the shoulder joint in patients with frozen shoulder is infiltrated with vascular tissue

SYMPTOMS

The symptomatology of patients with frozen shoulder is dominated by pain and extremely limited passive and active mobility in the shoulder joint. Patients with a frozen shoulder typically have a history of minor shoulder trauma to which they did not attach much importance until the development of symptoms that led them to see a doctor. Characteristic signs of the disease are pain that intensifies over time, which wakes the patient from sleep, palpation sensitivity in the area of ​​insertion of the deltoid muscle (shown in the figure below) and limited range of motion in the shoulder.



Increased sensitivity to deltoid muscle insertion is one of the signs of a frozen shoulder.

HOW IS A FROZEN SHOULDER DIAGNOSED?

Diagnosis of frozen shoulder is performed mainly on the basis of anamnesis and clinical picture, with the use of radiological methods to exclude other, potentially more dangerous conditions. X-ray images do not show significant bone and joint changes, although areas of reduced bone density, caused by inactivity, are often noticeable. Another method by which this disease can be characteristically proven is shoulder arthrography, for which the specific finding is a reduced volume of the joint capsule and the absence of an axillary cavity.

X-ray of a patient with a frozen shoulder does not show major features, except for slightly reduced bone density, which occurs as a result of inactivity

FROZEN SHOULD TREATMENT AND RECOVERY

Recovery can occur spontaneously, often within a year, somewhat less frequently over a longer period of time. In the treatment of frozen shoulder, it is important to use physical therapy methods to maintain range of motion and trophic of the shoulder girdle muscles, so that the shoulder remains functional once the disease recedes. Also, the therapy of this disease is aimed at reducing pain in the patient, which can be achieved in several ways.

Shoulder stretching exercises and oral non-steroidal anti-inflammatory drugs are most commonly used in combination, and if inflammation persists, the disease can be successfully controlled by “blockades,” injections containing a combination of a short-acting anesthetic and a long-acting corticosteroid. In this way, the inflammation is brought under control and the painful stimulus is reduced.

Conducting targeted physical therapy is of the utmost importance in maintaining the shoulder joint in optimal condition.

IS THERE A POSSIBILITY TO HAVE SURGERY IF I HAVE A FROZEN SHOULDER?

Operativni zahvat nužan je samo u iznimnim situacijama, kod perzistirajućih i dugotrajnih simptoma, kada se u općoj anesteziji izvrši manipulacija zgloba te se opusti stegnuta zglobna čahura. Pacijentima s ovim stanjem se, u slučaju adekvatnog i na vrijeme započetog liječenja, može garantirati uspjeh liječenja i regresija simptoma.


SHOULDER ORTHOPEDICS

From other sources on this topic

How to recognize a frozen shoulder?




In short


Polyclinic Ribnjak is a unique institution in the Republic of Croatia. It unites different branches of medicine, all in order to stay true to its slogan “Health and Beauty. Together”. Orthopedics, advanced sports diagnostics, functional and kinesiological rehabilitation, cosmetic surgery and treatments are the services we provide on a daily basis, professionally and in accordance with the latest professional standards.






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