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Encyclopedia > Frozen shoulder

Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff. Movement of the shoulder is severely restricted. The condition is sometimes caused by injury that leads to lack of use due to pain but also often arises spontaneously with no obvious preceeding trigger factor. These seemingly spontaneous cases are usually referred to as Idiopathic Frozen Shoulder. Rheumatic disease progression and recent shoulder surgery can also cause a pattern of pain and limititation similar to frozen shoulder. Intermittent periods of use may cause inflammation. This article is about the body part. ... The joint capsules or articular capsules form complete envelopes for the freely movable bone joints. ... This does not cite its references or sources. ... “Hurting” redirects here. ... Idiopathic means arising spontaneously or from an obscure or unknown cause. ... Rheumatism or Rheumatic disorder is a non-specific term for medical problems affecting the heart, bones, joints, kidney, skin and lung. ... “Surgeon” redirects here. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ...


Abnormal bands of tissue (adhesions) grow between the joint surfaces, restricting motion. There is also a lack of synovial fluid, which normally helps the shoulder joint move by lubricating the gap between the humerus (upper arm bone) and the socket in the scapula (shoulder blade). It is this restricted space between the capsule and ball of the humerus that distinguishes adhesive capsulitis from a less complicated, painful, stiff shoulder. People with diabetes, stroke, lung disease, rheumatoid arthritis, and heart disease, or who have been in an accident, are at a higher risk for frozen shoulder. Adhesive capsulitis has been indicated as a possible adverse effect of some forms of highly active antiretroviral therapy (HAART). The condition rarely appears in people under 40 years old and (at least in its idiopathic form) is much more common in women than in men. Frozen shoulder in diabetic patients is generally thought to be a more troublesome condition than in the non-diabetic population. [1] If a diabetic patient develops frozen shoulder then the time to full recovery is often prolonged. Biological tissue is a group of cells that perform a similar function. ... An adhesion is a fibrous band of scar tissue that binds together normally separate anatomical structures. ... A joint is the location at which two or more bones make contact. ... Synovial fluid is a thin, stringy fluid found in the cavities of synovial joints. ... Lubrication occurs when opposing surfaces are completely separated by a lubricant film. ... The humerus is a long bone in the arm or fore-legs (animals) that runs from the shoulder to the elbow. ... Grays Anatomy illustration of a human femur. ... Left scapula - front view () Left scapula - rear view () In anatomy, the scapula, or shoulder blade, is the bone that connects the humerus (arm bone) with the clavicle (collar bone). ... This article is about the disease that features high blood sugar. ... Stroke (or cerebrovascular accident or CVA) is the clinical designation for a rapidly developing loss of brain function due to an interruption in the blood supply to all or part of the brain. ... In medicine, pulmonology is the specialty that deals with diseases of the lungs and the respiratory tract. ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... Heart disease is an umbrella term for a number of different diseases which affect the heart and is the leading cause of death in the United States as of 2007. ... The term antiretroviral drugs is used to describe drugs used against HIV infection (HIV is an RNA retrovirus). ...

Contents

Prevention

To prevent the problem, a common recommendation is to keep the shoulder joint fully moving to prevent a frozen shoulder. Often a shoulder will hurt when it begins to freeze. Because pain discourages movement, further development of adhesions that restrict movement will occur unless the joint continues to move full range in all directions (adduction, abduction, flexion, rotation, and extension). Therapy will help one continue movement to discourage freezing and warm it. A medical doctor referral is needed before occupational or physical therapy can begin under law in most US states. Medical referral is not required for physical or occupational therapy in most Canadian provinces. This article is about the body part. ... A joint is the location at which two or more bones make contact. ... An adhesion is a fibrous band of scar tissue that binds together normally separate anatomical structures. ... The anatomical planes The anatomical position is a schematic convention for describing the relative morphology of the human body. ... The word physician should not be confused with physicist, which means a scientist in the area of physics. ... Occupational therapy refers to the use of meaningful occupations to assist people who have difficulty in achieving occupationally balanced lives. ... Physical therapy (or physiotherapy[1]) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. ...


Signs and diagnosis

With a frozen shoulder, one sign is that the joint becomes so tight and stiff that it is nearly impossible to carry out simple movements, such as raising the arm. People complain that the stiffness and pain worsen at night. Pain due to frozen shoulder is usually dull or aching. It can be worsened with attempted motion. A doctor, or therapist (occupational or physical), may suspect the patient has a frozen shoulder if a physical examination reveals limited shoulder movement. Frozen shoulder can also be diagnosed if limits to the active range of motion (range of motion from active use of muscles) are the same or almost the same as the limits to the passive range of motion (range of motion from a person manipulating the arm and shoulder). An arthrogram or an MRI scan may confirm the diagnosis - although in practice this is rarely required. Most orthopaedic specialists make the diagnosis of frozen shoulder by recognising the typical pattern of signs and symptoms. In medicine, a sign is a feature of disease as detected by the doctor. ... Occupational therapy refers to the use of meaningful occupations to assist people who have difficulty in achieving occupationally balanced lives. ... Physical therapy (or physiotherapy[1]) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. ... In medicine, the physical examination or clinical examination is the process by which the physician investigates the body of a patient for signs of disease. ... X-ray of a joint after injection of a contrast medium. ... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ...


Physicians have described the normal course of a frozen shoulder as having three stages:


Stage one: In the "freezing" or painful stage, which may last from six weeks to nine months, the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion.


Stage two: The "frozen" or adhesive stage is marked by a slow improvement in pain, but the stiffness remains. This stage generally lasts four months to nine months.


Stage three: The "thawing" or recovery, during which shoulder motion slowly returns toward normal. This generally lasts five months to 26 months.


Management

Management of this disorder focuses on restoring joint movement and reducing shoulder pain. Usually, it begins with nonsteroidal anti-inflammatory drugs (NSAIDs) and the application of heat, followed by gentle stretching exercises. These stretching exercises, which may be performed in the home with the help of a physical or occupational therapist, are the treatment of choice. In some cases, transcutaneous electrical nerve stimulation (TENS) with a small battery-operated unit may be used to reduce pain by blocking nerve impulses. Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ... Physical therapy can help restore lost functionality in many people. ... It has been suggested that this article or section be merged into Occupational therapy. ... TENS (Transcutaneous Electrical Nerve Stimulator) is considered a method of pain relief, and has a wide following for use in obstetric care particularly labour. ... Schematic of an electrophysiological recording of an action potential showing the various phases which occur as the wave passes a point on a cell membrane. ...


If these measures are unsuccessful, the doctor may recommend manipulation of the shoulder under general anesthesia to break up the adhesions. Surgery to cut the adhesions is only necessary in some cases. Joint manipulation is a type of passive movement of a skeletal joint. ... This article or section may be confusing for some readers, and should be edited to be clearer. ... “Surgeon” redirects here. ...


See also

Calcific Tendonitis (also calcific tenonitis or calcific tendinitis or calcifying tendinitis or calcified tendinitis or calcareous tendinitis or tendinosis calcarea or calcific tendinopathy) is a disorder characterized by deposits of hydroxyapatite (a crystalline calcium phosphate) in any tendon of the body, but most commonly in the tendons of the rotator...

References

  1. This article contains text from the public domain document "Questions and Answers about Shoulder Problems", NIH Publication No. 01-4865, available from URL http://www.niams.nih.gov/hi/topics/shoulderprobs/shoulderqa.htm
  2. This article contains text from the public domain document "Frozen Shoulder" , American Academy of Orthopaedic Surgeons, available from URL http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=162&topcategory=Shoulder

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External links


  Results from FactBites:
 
Frozen shoulder - Wikipedia, the free encyclopedia (655 words)
To prevent the problem, a common recommendation is to keep the shoulder joint fully moving to prevent a frozen shoulder.
With a frozen shoulder, one sign is that the joint becomes so tight and stiff that it is nearly impossible to carry out simple movements, such as raising the arm.
Frozen shoulder can also be diagnosed if limits to the active range of motion (range of motion from active use of muscles) are the same or almost the same as the limits to the passive range of motion (range of motion from a person manipulating the arm and shoulder).
ShoulderDoc.co.uk Shoulder and Elbow Surgery (345 words)
Frozen shoulder often starts out of the blue, but may be triggered by a mild injury to the shoulder.
Frozen shoulder may be associated with diabetes and is also seen in patients with scar tissue in their hands, a condition called Dupuytren¹s contracture.
However, since frozen shoulder may set in as a result of underuse or immobilization of the shoulder, it is important not to neglect a painful injury as it may lead to stiffness.
  More results at FactBites »

 
 

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