Although the exact cause of frozen shoulder is still unknown, it may occur after a shoulder injury or after prolonged immobilization of the shoulder, such as after surgery or an arm fracture. Diabetics do have a higher risk of suffering from frozen shoulder.
There is a school of thought that advocates that frozen shoulder may be caused by an autoimmune reaction, whereby the body’s defense system, which normally protects a person from infection, mistakenly begins to attack the tissues of the body instead.
Cardiac conditions like open heart surgery, angioplasty or peacemaker insertion that are unrelated to shoulder may also cause frozen shoulder. Many people are reluctant to move their shoulders after a heart procedure for fear of pain or affecting the chest wound. Immobilizing a joint seems to trigger the autoimmune response in some people, resulting in frozen shoulder.
Two key symptoms of frozen shoulder are shoulder pain and a very limited range of movement. A person with frozen shoulder is unable to move beyond a certain point, as if something were blocking the shoulder. He or she will feel very painful if he or she tries to move beyond that point, or sometimes at night. The tightness can cause difficulties in getting dressed, combing hair, or reaching across a table.
Frozen shoulder usually develops slowly in three stages with each stage lasting for few months.
During this stage, pain occurs with any movement of the shoulder.
Pain may begin subsiding during this stage. However, the shoulder becomes stiffer and the range of motion decreases notably. Patients should avoid extreme movements that cause pain during this stage; but they can and should continue normal use of the shoulder.
During the thawing stage, the condition may begin to improve. Although this healing process may just occur on its own, help from a doctor is usually needed.
In order to determine the condition, it is advisable to consult a doctor so as to rule out other conditions or injuries such as a rotator cuff tear. Sometimes, X-ray, an arthrogram or magnetic resonance imaging (MRI) may be used to help the diagnosis.
To prevent from frozen shoulder after a cardiac procedure, patients must follow the advice given by the healthcare professionals in the hospital. For example, during the first 2 week after a pacemaker insertion, the patient should limit his or her shoulder movement to about 90 degree. Then, he or she should gradually increase the shoulder movement, unless otherwise instructed by the doctor. After undergoing angioplasty or open heart surgery, it is generally safe to perform simple, gentle stretches of the shoulder as advised by the physiotherapist, unless otherwise instructed by the doctor.
Medical treatment may include pain-relief and anti-inflammatory medications, steroid injections, manipulation under anesthesia and arthroscopic release surgically. It is better to seek advice from doctors on the various types of treatment options available.
Usually but not necessarily, doctor may refer a patient to a physiotherapist who may offer pain-relief treatment options, help mobilize the shoulder joint and teach the appropriate exercises to gradually increase the range of shoulder movement and eventually strengthening exercises.