Summary

Generally

Frozen shoulder means that you get shoulder pain which after a while solidifies and leads to poorer mobility. This is because the joint capsule, which surrounds and stabilizes the shoulder joint, contracts and becomes rigid. Sometimes you also get frozen shoulder in the other shoulder.

The disease develops over several months. Eventually, the shoulder usually heals itself, although healing takes a long time. From the onset of the trouble of being healthy, it often takes two to three years.

It is quite common to have some pain and stiffness afterward, but it rarely affects everyday life.

About three out of a hundred people get the disease that is most common between the ages of 40 and 60. It is not clear what frozen shoulder is due to, but having diabetes increases the risk of getting the disease.

Symptoms of frozen shoulder

The first symptom of a frozen shoulder is usually that the shoulder hurts when you touch it. Over time, it starts to become stiff and difficult to move.

Often it hurts most when you lie down and sleep.

Treatment

Usually pain relief and physiotherapy, also called physiotherapy, suffice. What medicines to take and how often to take them, the doctor advises, but the most common is that you use regular pain tablets.

Sometimes, at the beginning of the illness, cortisone can be relieved to relieve the pain.

At the physiotherapist or physiotherapist, you can get pain relief with cold, heat, acupuncture or transcutaneous electrical nerve stimulation, so-called tens. You can also get advice on exercise exercises.

It may be necessary to operate the shaft, but it is very unusual.

When to seek care?

If you are in pain or stiff in the shoulder, you can contact a health care center. You can also contact a physiotherapist, chiropractor or naprapathy.

What happens in the body?

Frozen shoulder is a disease that causes the shoulder to hurt first and then solidify after a while. The disease heals on its own, but you can still have problems such as pain and poor mobility. To regain as much of the mobility as possible in the shoulder, treatment with pain relief and physiotherapy is usually needed. It also happens that you need to operate the shaft.

The body’s most moving joint

At the shoulder joint, the upper arm bone and the shoulder blade meet. The trail is a ball joint and can be moved in three planes. You can, therefore, swing your arm forward and back, move it in or out of the body all the way up over your head and rotate it. The shoulder joint is the body’s most moving joint. In the joint capsule surrounding the joint is the lubricating joint fluid.

The shaft becomes rigid

Frozen shoulder causes the joint capsule that sits around the shoulder joint to shrink. The disease means that part of the shoulder joint is inflamed, but it is not clear why you get frozen shoulder and also what role inflammation in the shoulder joint is to get the disease. If you have diabetes you are at greater risk of getting frozen shoulder, this applies to both type 1 and type 2 diabetes.

As the joint capsule shrinks and contracts, the mobility of the shaft decreases and eventually it can become quite rigid. When the shaft starts to become stiff it aches and it hurts when you touch it.

It can take a long time to recover

When you have a frozen shoulder, it takes a long time from the illness until you are healthy, on average, about two to three years.

The disease is usually divided into three phases. During the first phase, which usually takes a few months to just over six months, the stiffness increases while the shoulder hurts. The next phase is called the rigid phase and lasts from a few months up to a year. Below it, the shoulder is stiff and difficult to move, but the pain decreases. During the third phase, the mobility in the shoulder is regained, but usually, the mobility becomes somewhat worse than before the disease. The healing phase lasts for six months to a year, but maybe longer.

Most commonly between the ages of 40 and 60

About three out of a hundred people get frozen shoulder. If you are right-handed, it is somewhat more common for the left shoulder to be affected, if you are left-handed, the opposite applies. Some who have had the disease also get frozen shoulder in their other shoulder, but it is unusual for both shoulders to be affected simultaneously.

The disease is most common between the ages of 40 and 60 and more women than men get it. You rarely get frozen shoulder before the age of 40.

The mobility of the shoulder may be impaired

It often takes about two to three years to recover after a frozen shoulder. It is quite common that the pain does not go over completely, but that you can live with a certain pain in the shoulder and that you can usually move the shoulder slightly worse than before you became ill, but it rarely affects everyday life.

Symptoms and diagnosis

Often starts creeping

Frozen shoulder often starts creeping with pain in the shoulder as you touch it. Then the shaft starts to become stiff and the stiffness increases with time. The stiffness can come up to a couple of months after feeling the first pain and can, for example, make it difficult to comb or brush your teeth. You also get pain in the shoulder and it is common that it hurts the most at night when you lie down and sleep.

Pain and pain make you seek care

When you meet the doctor you are told about their problems, how long you have had them and how they feel. Usually, it is not the rigidity that makes you seek care, but the shoulder hurts when you touch it. If you seek the doctor at the beginning of the illness, you have no stiffness in the shoulder. Then it can be difficult for the doctor to diagnose a frozen shoulder.

In order for the doctor to be able to determine if you have a frozen shoulder, you have to make certain movements. The clearest sign that you have the disease is that you have a hard time turning your arm out, even if the doctor helps. It is also difficult to stretch the arm straight up.

In order for the doctor to safely rule out other causes, it is possible to be examined by x-ray. If you have the disease frozen shoulder, no changes are visible on the x-ray.

Getting a sick message

Frozen shoulder takes a long time to heal and it can feel heavy to know that you have to live with the disease for two to three years. You may need to talk to a doctor about your situation, for example.

During the illness, most people usually do most of the chores in the home with one arm, but sometimes you may need help. If you have a job where you use the affected shoulder, you may need to be on sick leave for a while, or get other work.

Care and treatment of frozen shoulder

When to seek care

If you are in pain or stiff in the shoulder, you can contact your health care center. There, a doctor can check if the problems are caused by a frozen shoulder or if they are caused by some other illness. You can also contact a physiotherapist, chiropractor or naprapathy directly.

Treatment of frozen shoulder with drugs

If you have frozen shoulder, pain relief, and physiotherapy are usually sufficient. The pain in the shoulder is usually alleviated with pain tablets containing the active substance paracetamol, for example, Alvedon or Panodil. Paracetamol used at the right dose produces few, or no side effects.

You can also use drugs that have both anti-inflammatory and analgesic effects, such as NSAIDs. An example of NSAID that is often used when you have a frozen shoulder is naproxen. Another NSAID that can be used is ibuprofen, for example, found in Ibumetin or Ipren. One disadvantage of NSAIDs is that they can irritate the gastric mucosa.

If you are over 75, have any cardiovascular disease or have previously had a stomach ulcer, you should use paracetamol instead of NSAIDs.

What tablets to take and how often to take them, the doctor advises. It is quite common that you need to be treated with different pain tablets at the same time.

Sometimes you can get a syringe of cortisone in the shoulder joint at the beginning of the illness. Cortisone can relieve pain.

Treatment of frozen shoulder by the physiotherapist

In the physiotherapist, also called physiotherapist, you can get pain relief with cold, heat, acupuncture or transcutaneous electrical nerve stimulation, so-called tens.

When you get pain relief with cold, the physiotherapist often does it with cooling bags. The heat treatment of a frozen shoulder is obtained, for example, with heat bags or a heat lamp. At the dent, the physiotherapist attaches electrodes to the skin. Weak electrical impulses then stimulate the nerves and relieve the pain.

It is mainly during the healing phase that frozen shoulder is treated with physiotherapy, but it is usually good to do so throughout the illness period. The treatment is mainly about relieving the pain, but also to train the strength of the shoulder. Sometimes physical therapy can also help give the shoulder joint better mobility.

Read more about physiotherapy in case of neck, shoulder and back problems.

Block nerves from pain

In very severe pain, you can get so-called nerve blocks from an anesthetist. This means that an anesthetic is injected at a larger nerve branch leading to the shoulder so that the nerve branch is blocked and does not cause pain impulses. How long the pain is relieved varies from person to person. Usually, you get the treatment of a frozen shoulder in the hospital.

Several operating methods

If you have major problems such as severe pain or stiffness that makes you unable to work or manage your everyday life, you can sometimes be operated on. The operation means that the shrunk joint capsule is either cracked or split. The surgery is done in a hospital and you can usually go home the same day. There are different operating methods.

The most common surgical procedure is for the doctor to crack the capsule by forcibly moving the arm in different directions. During this treatment, you are anesthetized with anesthesia. Sometimes the doctor first injects fluid into the joint capsule to widen it and then moves the arm in different directions.

Pitch hole surgery, also called arthroscopy, means that the doctor inserts a tube with fiber-optics into the joint. Then the doctor divides the shrunk joint capsule. Even during this treatment, you are anesthetized with anesthesia.

Risks with surgery

The surgical method of fracturing the joint capsule by moving the arm in different directions sometimes leads to damage to the shoulder joint, tendons and ligaments. The operation can also cause a fracture of the upper arm bone, but it is very uncommon.

After surgery

You usually get significantly better from an operation and that usually means that the shoulder mobility increases and you get less pain. The first time after surgery you may have difficulty using the shoulder because it hurts, but when the shoulder gets better you can start with physical therapy again.

Two months after surgery, the pain in the shoulder is usually reduced. In the longer term, you usually feel better or as good compared to if you had not done any surgery.

Frozen shoulder also on the other shoulder

About one-tenth of those who have frozen shoulders also get frozen shoulders in the other shoulder. In that case, it usually happens within five years and after the first shaft has healed. It is rare that you get frozen shoulder twice in the same shoulder.

Ehtisham Nadeem

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