One of the complaints that brings patients seeking pain relief and increased mobility to the Long Island Spine Rehabilitation Medicine is frozen shoulder, medically known as adhesive capsulitis. Our doctors — all of whom are physiatrists who specialize in pain management and rehabilitation — have a well-earned reputation for a high level of skill in frozen shoulder treatment as well as for compassion when treating patients who are suffering.
What is frozen shoulder?
Frozen shoulder is aptly named since it causes not only pain but stiffness and greatly restricted mobility of the shoulder joint. It occurs when the shoulder capsule, the strong connective tissue that surrounds the ball-and-socket joint of the shoulder, thickens to form adhesions and becomes tight. In addition, the amount of synovial fluid that is naturally present to lubricate the shoulder joint and ease movement diminishes. These two occurrences make it increasingly difficult to move the shoulder until it seems to be frozen in place.
The symptoms interfere with your normal routine because they include seriously restricted mobility as well as dull, aching pain. The pain is usually located over the outer shoulder area and into the upper arm; it may worsen at night, interfering with sleep.
In most cases, frozen shoulder develops gradually and is described as having three stages:
- Freezing stage — during which all movement of the arm or shoulder is painful and your range of motion begins to become limited
- Frozen stage — during which pain diminishes, but your shoulder becomes stiffer and more difficult to move
- Thawing stage — during which shoulder range of motion begins to improve.
Perhaps the worst part of the condition is that each stage can last from many weeks to many months. This is why getting an early diagnosis and prompt frozen shoulder therapy is so important.
No one has yet pinned down the cause or causes of frozen shoulder, though people with certain diseases and those who have had to immobilize their shoulder for a length of time, as after a fracture, are more prone to developing the condition. Other risk factors for frozen shoulder are:
- Being between 40 and 60 years of age
- Being female
- Having suffered prior shoulder injuries, such as torn rotator cuffs
- Having had a stroke or mastectomy
- Certain disease conditions — diabetes, thyroid or cardiovascular disease, tuberculosis, Parkinson’s disease
- Long periods of inactivity, such as during recovery from surgery
- Advanced arthritis
Whatever the reason you develop a frozen shoulder, adhesive capsulitis physical therapy and interventional procedures using injections or infusions can be remarkably helpful in lessening your pain and increasing your range of motion as you heal.
Diagnosis of Adhesive Capsulitis
Although the symptoms of frozen shoulder are quite obvious, it is extremely important to have a correct diagnosis of the condition, and any underlying disorders, so that you receive appropriate treatment. At Long Island Spine, our experienced doctors follow a protocol designed to ensure accurate diagnosis, including:
- Taking a complete medical history
- Performing a full medical exam that includes an assessment of both active range of motion (how much you can move your shoulder by yourself)and passive range of motion (how much the doctor can move your shoulder for you)
- Interpreting imaging tests, such as X-rays, MRI scans, and ultrasound
Imaging tests, which provide pictures of bones and soft tissue give us a better understanding of other shoulder problems that may underlie your adhesive capsulitis symptoms.
Treatments of Frozen Shoulder
Because adhesive capsulitis takes a long time (up to 3 years) to heal, it is crucial to have ongoing frozen shoulder treatment to ensure that progress is being made and that there is no backsliding. The methods of frozen shoulder therapy used at Long Island Spine are all safe, effective, and noninvasive. They include:
- Frozen shoulder physical therapy involving range of motion (ROM) exercises
- Heat therapy to loosen the shoulder joint before exercise or manipulation
- Injections procedures into the capsule of the shoulder joint utilizing ultrasound guidance
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen (e.g. Advil)
- Acupuncture (available in our Great Neck and East Meadow offices)
- Local application of pulsed electromagnetic field therapy (PEMF) to promote healing and circulation and reduce inflammation
PRP, platelet rich plasma therapy, may also be considered in select instances of more chronic shoulder pain and involves putting a sample of the patient’s own blood through a centrifuge to isolate blood platelets which are then re-injected into the patient. Platelet-rich plasma has proven to be effective in speeding the healing process in some injuries.
In Some Cases, Surgery Is Necessary
While in most cases, the noninvasive adhesive capsulitis treatments of Long Island Spine are successful in relieving the pain and immobility issues of frozen shoulder, infrequently surgery may be required. The most common surgical procedures performed for this condition are shoulder arthroscopy or manipulation under anesthesia. When surgery is called for, our doctors will refer you to a well-respected surgical colleague for the operation and be available to help you with treatment during postsurgical recovery.
Don’t Be Left Out in the Cold with Your Frozen Shoulder
The sooner you contact the capable physiatrists at Long Island Spine, the more quickly you will begin healing from this painful, debilitating condition. We are well-versed in all types of noninvasive frozen shoulder diagnoses and therapies and will customize a frozen shoulder treatment plan to suit your particular needs. You will find our doctors, physical therapists, and other personnel to be not only friendly and efficient but empathic. We want nothing more than to relieve your pain, increase your mobility, and restore your quality of life.