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Frozen shoulder

A repetitive stress injury

Medically referred to as adhesive capsulitis, Frozen shoulder is a disorder in which the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, restricting motion and causing chronic pain.

Movement of the shoulder is severely restricted. Pain is usually constant, worse at night, and when the weather is colder; and along with the restricted movement even small tasks may become impossible. Certain movements or bumps can cause sudden onset of tremendous pain and cramping that can last several minutes.

True frozen shoulder (adhesive capsulitis) is more common in women than men and typically presents between the ages of 40 and 60 years. There is a higher incidence in people with diabetes. In these people it is usually present at a younger age, is typically less painful and does not respond as well to treatment.

Holistically; Frozen shoulder is a symptom of a life out of balance and probably has a range of influencing factors including nutrition, lifestyle and exercise.

Diagnosis

Frozen shoulder is characterised by gradual and spontaneous onset of pain and global restriction of movement of the glenohumeral joint. Pain can be severe, especially at night. Patients report substantial functional limitation with activities of daily living such as dressing and reaching. Diagnosis is based on the history and clinical examination and has been described as a “clinical diagnosis of exclusion”. The cause or aetiology is typically unknown. However, there can be a history of minor trauma and occasionally significant injury. The stiffness experienced with frozen shoulder is the key clinical feature differentiating frozen shoulder from rotator cuff disorders.

There will often be related pain in the neck and upper back, but if posture is poor, there may be other chronic symptoms.

Resolving

As there is no clearly defined cause,  there is no one treatment.  What happens is the sleeve that surrounds the shoulder joint, known as the capsule, becomes swollen and thickened to form bands of scar tissue inside the shoulder capsule which reduces the space for the upper arm bone in the joint.  This limits movements and causes pain with movement although in sever cases, pain may become chronic and immobilise the person.

Doctors and modern medicine use analgesia to manage pain according to pain severity and also employ intra-articular corticosteroid injections.  In more extreme cases surgery may be performed.

Holistic treatments

  1. Massage - rest and exercise:
    1. A first aide solution is to give/have a full body massage to relax the entire body in order to give the person a more relaxed sense of self.
      • Notes to therapists;
        Take care when massaging near the affected area and do not ignore it.
        Follow the pain and typically there will be areas of stress in the shoulder, upper back and neck as well as the forearms and hands.
        Use hot rubs to help soften the tissues
        Combination of deep tissue/myofascial release and relaxation
      • Apply gentle massage including the stretches and shoulder manipulation as far as comfortably possible.
      • Self care massage:
        Massage as feels comfortable - no pain - and it helps to use a hut rub like tiger balm.
  2. Yoga
    1. Yoga stretching helps to break up the scar tissue, but this must be done with caution with guidance from a qualified instructor.
      • the body must be steady in poses and the stretches
      • work both sides of the body evenly
      • read more
  3. Acupuncture
    1. Acupuncture or acupressure massage plus exercise may achieve improvements.
  4. Rest
    The affected are needs exercising, but it also needs rest which is best achieved through yoga relaxation.

Management

Typically this condition takes months to come right, combine exercise, regular weekly massage with detailed attention to other areas of stress in the body and life.

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