Frozen Shoulder Treatment

Frozen Shoulder Treatment - How to Live With Frozen Shoulder Symptoms
By Gordon Cameron

If you've read my other frozen shoulder articles or visited my frozen shoulder website (details below) then you now know a great deal about frozen shoulder and about the options for frozen shoulder treatment.

I'm sure that the knowledge you’ve gained is already helping you to cope with your frozen shoulder symptoms and I truly hope that you’ve found a doctor or therapist who has helped you find some pain relief.

But what if you haven't - or if you've gained only partial relief from your frozen shoulder treatment? What follows are my top tips for surviving with your shoulder symptoms until nature works her magic. Remember - stay positive - you will get through this and you will soon return to full normal function without pain or discomfort.

First tip for frozen shoulder treatment: Keep your shoulder warm!

I know that it almost sounds too obvious but it works! Use warm or hot compresses (or buy a heating pad) and use it over your shoulder four or five times a day for fifteen minutes at a time. It also works well applied in your armpit - the warmth travels up into the shoulder.

Many of my frozen shoulder patients have also found great relief - particularly at night - by using a heated pad or thermal blanket. There are a variety of moderately sophisticated products available, and a range of other inexpensive options, some of which you simply heat in the microwave before use. You can find details of these products on the website links below.

Second tip for frozen shoulder treatment: Sleep with an extra pillow!

No - not a pillow for your head, but a pillow under your shoulder on the affected side. Loss of sleep at night makes it much harder to cope with shoulder pain during the day and if you roll onto the painful shoulder when asleep you will wake up in pain. Sleep on your back with the extra pillow under your sore shoulder.

Frozen shoulder treatment tip number three: Massage helps your shoulder pain!

The pain of frozen shoulder comes from the joint but the surrounding muscles can become very tired and tense. Massage can produce good short-term relief of pain. A family member, a friend or professional masseur could help with this. As with heated pads, there are a number of self massaging devices available and you can find more details on my website by following the links below.

Fourth tip for frozen shoulder treatment: Try dietary supplements!

Natural products like glucosamine or fish oils have been shown to ease joint pains and stiffness. Some herbal remedies have pain-relieving properties. This does not work for everyone but might be worth a try for your frozen shoulder pain. I’ve had particular success recently with products based on honeybee venom. The use of honeybee venom is based on the long-known fact that bee keepers (who often get stung) very rarely develop arthritis or problems with their joints and muscles.Now - the braver amongst you (not including me I hasten to add) might volunteer for traditional "bee sting therapy" where you are subjected to repeated stings from a succession of bees held in tweezers!

Most of us would feel more comfortable simply applying the bee sting venom in the form of a balm to be rubbed into the painful or stiff area. In truth, I was a bit sceptical about all of this at first, but a large number of my patients have had great benefit from its use and I recommend you give it a try if you are interested. It's certainly a very natural way to obtain pain relief.

Fifth tip for frozen shoulder treatment: Buy or borrow a TENS machine!

TENS - or trans cutaneous electrical nerve stimulation is a good and safe way to induce pain relief and some muscle relaxation. It works by stimulating the skin nerves and thus encourages the brain to pay less attention to the incoming pain signals from the joint. It doesn't seem to work for everyone but may be well worth a try.

Frozen shoulder treatment tip number six: Strap or support the arm from time to time!

If your shoulder is in the frozen stage then support from a simple strap can be of great value. Be careful of strapping too much in the other phases of the condition. You may simply encourage the shoulder to stay stiff for longer. As before, the website links below give details of strapping and support products.

Final tip for frozen shoulder treatment: Consider short term medication to improve sleep

People are naturally concerned about becoming dependent on sleeping medication - justifiably so. But for short term use there is no risk of dependency or addiction. Consider asking your doctor for a sedative medication if your frozen shoulder is stopping you from sleeping.

Dr Gordon Cameron is a specialist in joint pain based in Edinburgh, Scotland. He is an expert in frozen shoulder treatment and in whiplash injury

The Cameron Medical Website also contains extensive information on the treatment of gout
Dr Cameron has also created an electronic book on the subject of frozen shoulder. You can explore it and download a copy on his website by following the links to Frozen Shoulder above.

Article Source: http://EzineArticles.com/?expert=Gordon_Cameron
http://EzineArticles.com/?Frozen-Shoulder-Treatment---How-to-Live-With-Frozen-Shoulder-Symptoms&id=17759

Symptoms Of Frozen Shoulder - What You Need To Know

With all of the advances in medicine these days one does not need to suffer unduly with a condition such as adhesive capsulitis. Treatments vary from simple pain management to surgery, although the most conservative treatment and most effective is physical therapy. But before heading down to your local PT clinic (you'll need a doctor's prescription first), you might want to know what the symptoms of frozen shoulder are. Determining if you have this condition is the first crucial step to seeking the correct treatment for this or any other medical condition.

I'm often asked in the clinic "What are the symptoms of adhesive capsultis?" While this seems like a straight forward question with seemingly black and white answers, the fact of the matter is that the answers depend on what stage of frozen shoulder syndrome the person may be in. The best answer to that person may involve describing the general symptoms, then describing symptoms that are not associated with frozen shoulder or may be indicative of a different or even more serious medical condition. It's safe to say, and may seem obvious, that the symptoms of frozen shoulder are painful shoulder movement and/or stiffness. Depending on the stage of frozen shoulder (adhesive capsulitis) a person is in, there may be no pain but increased stiffness and conversely, severe pain with range of motion but no limiting stiffness.

Why Does This Matter?

Early intervention in the case of any medical condition decreases the likelihood of the development of more serious problems and may prevent long term complications. Knowing and acting on this fact means that the treatment must be specific to the diagnosis. Treating a frozen shoulder with rotator cuff exercises alone will do little to resolve the condition and may make the problem worse in some cases. Treating a rotator cuff injury when the root cause of pain is due to a cervical (neck) disc impingement is a waste of time. This may seem obvious, but I see it happen all the time when someone attempts to self-diagnose and treat their shoulder pain. "Yes" answers to the following questions about shoulder pain may indicate a condition other than frozen shoulder.

* Do you have radiating pain in to the forearm or hand?
* Do you have tingling or numbness of the fingers along with shoulder pain?
* Is your shoulder pain present when resting or not moving your shoulder?
* After using your arm/shoulder such as when brushing your hair or putting on your belt, does the shoulder pain last for more than 30 minutes?
* Is there frank weakness with gripping or holding objects?

"No" answers to the above regarding your shoulder pain and stiffness do not necessarily mean you have a frozen shoulder but can prevent unnecessary treatment where further diagnosis and alternate intervention may be indicated.

When you have a correct diagnosis the next crucial step is getting proper treatment. Visit Frozen-Shoulder-Help.Info for the latest evidence-based conservative treatment to end your shoulder pain. Symptoms Of Frozen Shoulder originally posted on EzineArticles.

Shoulder Manipulation - Should I Or Should I Not?

To start with, let me say up front that I've never had a shoulder manipulation under anesthesia. I treated my own frozen shoulder with great success (with a little help now and then from co-workers and my wife). I have however treated many a patient after having this procedure, the vast majority of which I did not have the opportunity to treat conservatively prior to the procedure. This makes the argument as to whether it was truly beneficial over tried and true physical therapy difficult to support.

I can say this however, not one single soul came to me after a shoulder manipulation with full range of motion. This makes sense though when one considers what takes place during this procedure. The idea is to take a shoulder which is frozen due to "tiny adhesions" around the joint capsule and forcefully take it through it's full range while the patient is asleep. Sounds simple, right? What typically takes place though is additional trauma to the shoulder's joint capsule, and/or possibly to the soft tissue surrounding the shoulder complex. This leads to a natural imflammatory reaction after the event, followed by swelling, muscle guarding, and believe it or not, more scar tissue eventually laid down in the shoulder.

The hopes of a quick fix solution can quickly fade as now more therapy and joint mobilization is required to return the shoulder to a functional state. The point of stating all of this is not to imply that a shoulder manipulation is never necessary. There are, in fact, some cases where this is the best option -- usually because the patient was inconsistent or non-compliant with their conservative program, or possibly because their pain threshhold was so low that they could not endure any amount of stretching or exercise during therapy sessions. The main point is to educate the patient that this procedure is not meant to be a quick fix, but rather a last resort if all else fails.

A properly designed program of stretching and movement can, in most cases, return a great deal if not all of a shoulder's previous range of motion. If results are not coming as quickly a one desires then he/she should consider the therapist's experience in treating frozen shoulder syndrome, how long the patient has had the condition, and how long they have tried conservative measures. My experience has taught me that persistence and properly applied exercise is the key to treating adhesive capsulitis successfully. Again, a shoulder manipulation should be the last in line of treatment options.

Reaching Behind Back Exercises - Frozen Shoulder Treatment

If you have adhesive capsulitis and you've lost the ability to reach behind your back, you are definitely not alone. In the middle stages of this condition it can suddenly be almost impossible to put on a belt, bra, or even scratch your back. In some cases just pulling up your pants becomes a major challenge. Frozen shoulder treatment for these activities is relatively simple if the patient is consistent and patient. In the next couple of paragraphs I've listed a few "reaching behind back" exercises, or formally called "internal rotation" exercises.

To do something as simple as reach behind your back, your shoulder must have two ranges of motions: 1) Shoulder extension, and 2) Internal rotation. You must have both of these in order to have the range of motion to put on a belt or fasten a bra (assuming this is not done from the front). The following exercises worked wonders for my internal rotation:

• Hold a towel with the hand of your non-involved arm and throw it over your opposite shoulder. Then grab the other end with the hand of your non-involved arm. Gently pull with your non-involved arm until a gentle stretch is felt. Hold initially for 10 seconds and repeat. Later, try to increase you hold time up to 30 seconds. This exercise is for those who have a little internal rotation to begin with.
  
• Hold a broomstick behind your back with both hands, palms facing behind you. Your elbows should be kept straight throughout the exercise. Stand fully erect with good posture and lift your hands away from your body (backwards). Hold 10 seconds, again building toward 30 seconds.
  
• Hold a broomstick in the same manner as the beginning of the above exercise. Try to slide your hands together until they meet. Don't worry if they don't meet to begin with, just keep trying. A mild to medium stretch or achy pull should be felt, but no sharp pain. The key to making this work is to do it several times in short bursts throughout the day. Stop if any sharp pain is felt.
• Lie semi-turned on the side of your involved shoulder (not fully on your side and not fully flat of your back). Slide your elbow/upper arm about 20 inches away from your side. Bend the elbow of the bad shoulder to ninety degrees (like an "L"). Next, use the opposite hand to gently push the other hand towards the bed while keeping the "L" shape or 90 degree bend in the elbow. Hold 10 seconds and repeat 10 times.
  

The previous frozen shoulder exercises will help to return the crucial ranges of motion needed to perform simple tasks involving internal rotation. They should be performed with care and caution and only under the guide of a physician or licensed clinician.

Physical Therapy Or Surgery - Which Is Best For A Frozen Shoulder?

You may have gotten the bad news from your doctor - "You have a frozen shoulder". Worse yet, he or she may have told you the terrible statistics regarding this condition: A frozen shoulder can take up to 2-3 years to heal on it's own. Now that's awful news or good news depending on which side of the coin you are viewing. On one hand 2-3 years suffering through a stiff and painful shoulder sounds like pure hell. On the other hand at least there's hope that your condition will improve and may not be permanent.

Personally, I don't like the sound of living with gut wrenching pain every time I try to reach to open a door or get a glass out of my kitchen cabinet. I want pain relief now, not 24-36 months from now. Your doctor may even suggest surgery or physical therapy. But which is best?

Surgery for a frozen shoulder involves arthroscopic methods which are supposed to release the tiny adhesions that have formed between the joint capsule and rotator cuff tendons. Anytime surgery is done anywhere on the body there is risk for infection. Therefore the risk may significantly outweigh to potential benefit, particularly if your immune system is down for any reason. Also if you are diabetic then you can look forward to slow healing times.

Another type of "surgery" that may be suggested is not really surgery at all. I'm speaking of manipulation under anesthesia. While the risk for infection is not present, you still have all of the risks associated with being put under anesthesia, including death. The risk of death, however small, is never an option to me, that is unless the pain is so bad that death would be a welcome option.

Physical therapy for frozen shoulder involves performing specific exercises at frequent intervals to increase shoulder range of motion (ROM). Increasing range of motion will lessen the pain and stiffness as adhesions are released. Physical therapy also involves joint mobilization by a trained therapist which loosens the joint capsule allowing for greater ROM. Your therapist may also introduce modalities such as ultrasound (typically used for focused deep heat), electrical stimulation (for short-term pain relief), and massage (relaxes spasms and tight muscles). Physical therapy, if performed in a structured program designed for this condition, can significantly reduce the chance of permanent dysfunction and can hasten recovery.

So when faced with the decision between physical therapy or surgery to treat a frozen shoulder, in my opinion, physical therapy wins hands down. It's simple - the benefits outweigh the risks. However even the best exercise can be risky without a proper diagnosis, therefore consult with your doctor before beginning any program or treatment for a frozen shoulder.

Top Frozen Shoulder Remedies

After suffering through the pain and debility of a frozen shoulder back in 1998, I finally realized what my physical therapy patients had been talking about. Not that I wasn't listening, but I mean I finally understood their desperate cries and the reasons they sought relief in the form of home frozen shoulder remedies. With this type of pain an individual will try most anything, including the absurd, to find a relief from this type of pain. Now I still stand firm on the fact that a good, organized physical therapy program is the best frozen shoulder treatment -- this based on the outcomes I see with most of my patients. However, not all patients subscribe to diligently following a program of exercise and stretching, but those that do will eventually break the cycle of pain and debility.

Frozen shoulder remedies have their place, though, despite their strangeness at times. Therefore I will list below the top frozen shoulder remedies as told to me over the years. Remember that some of these are anecdotal and anyone following them without advice from a doctor is doing so at their own risk -- the risk of increasing pain, dysfunction, or the risk of the remedy providing nothing in the way of relief.

1. Mustard Poultice -- This one is still used, mostly by the elderly. It consist of mustard powder mixed with water to form a paste. This paste is wrapped in cheesecloth or muslin cloth and applied to the affected area then covered with plastic wrap.
2. TENS unit -- These units are small portable electrical stimulation units which provide a current to the involved area. They have been widely used in physical therapy and by chiropractors as an adjunct to frozen shoulder treatment. They are really a "coping mechanism" meant to help the patient "tune out" the shoulder pain by irritating the skin. This works by bombarding the sensory nerves with electrical stimulations which override the nerves that signal pain to the brain (simply put). They are NOT the cure for a frozen shoulder.
3. Epsom salt bath -- The warm water does more for relief than the salts do. The idea is that the salts some how "draw" out the toxins that cause pain.
   
4. Auto part lubricant -- I'll avoid using the trademark name of this one, but it won't be hard to guess. Starts with a "W" and ends with a number. This remedy is more of a skin irritant and does nothing to heal a frozen shoulder.
   

These are the top remedies I hear of from some of my patients. I typically do not argue with anyone believing that they help (TENS actually does help with muscle spasm), but rather point out to the patient that there are other solutions that provide more lasting relief. Besides, who am I to argue that something does not work if it does work in the patient's mind (placebo effect).

Frozen Shoulder Therapy Massage

Will Massage Help My Frozen Shoulder?

The benefits of massage in frozen shoulder therapy are numerous. Besides just "feeling good" a massage calls in to play the release of pain inhibitors which can often sustain relief hours after receiving the massage. The type of massage most effective is "trigger point" massage and can be viewed in this video.

Trigger point massage involves applying pressure to particularly painful areas in the rotator cuff which contribute to stiffness and soreness when attempting to move the affected shoulder. Although a trained massage therapist is most effective in determining these trigger points, anyone can apply the massage and find these areas through feedback from the sufferer of the frozen shoulder.

Before beginning the massage it's best to apply moist heat for approximately 10 minutes to the affected shoulder. When applying the massage use a scent-free massage lotion or cream to reduce friction.

It's best to start with the person lying on their side with a pillow under their affected arm. The person applying the massage should start with "stroking" the affected arm. This induces relaxtion initially which is "key" to maximizing the effects of the massage. Next, gradual increasing pressure should be applied in a circular fashion to the back and side of the shoulder, taking note of painful trigger point areas as the patient responds.

Once a trigger point is found, the area should be worked on for 2-3 minutes before moving on to the next area. After completing massage to the shoulder for about 15-20 minutes, the patient should be left to lie in a relaxed position for another 5 minutes before getting up.

More information regarding frozen shoulder exercise and treatment can be found at http://www.squidoo.com/Melt_Frozen_Shoulder

Frozen Shoulder Pain Relief - How Long Does It Take?

I hate to sound wishy washy, but the length of time to get frozen shoulder pain relief depends upon a number of factors, even with a good frozen shoulder program. As much as I would like to give a general "catch all" answer but it honestly would be misleading. Therefore I will try to break it (pain relief time it takes) down:
(The following assumes the person is in stage II freezing stage -- These are my statistics based on clinical treatment, NOT nationwide or CDC statistics.

• If you are greater than age 45 (most frozen shoulder sufferers are) then you are in the "takes longer" category. Here, generally in my experience, relief comes in spurts with consistent exercise but I have typically seen significant progress with range of motion in about 3-4 weeks. If you are attending therapy 2-3 times per week with a trained manual therapist who is performing joint mobilization then this time frame is less. Remember, you must gain range of motion before you will have any lasting pain relief.
  
• If you are diabetic then you also fall into the above category. This is just a fact for just about anything healthwise diabetics go through. Here, the diabetic patient, in addition to consistent exercise, joint mobilization, and stretching, must pay strict attention to his/her diet. If you are able to do cardiovascular exercise, then this will help as well. A good cardio program, believe it or not, will help significantly. This has to do with oxygen exchange and bloodflow without getting too complicated. For diabetics - 6-10 weeks for significant range of motion gains. Pain relief will follow.
• If you are less than 35 years of age you also fall into the above category. This has nothing to do with physiological factors, but rather is an issue of compliance -- This age group typically has kids, a full time job on the upward career path, busier schedule, etc... and therefore will devote less time to consistent exercise.
• If this is your second or more frozen shoulder then you typically will get over it quicker. This has to do with previous knowledge and earlier recognition and initiation of treatment.
• The group that I see with the quickest recovery is female and 35-45. By contrast I see less patients in this category. I have actually treated individuals in this group and seen significant gains in ROM within 2 weeks!
• Sufferers of frozen shoulder pain in the age group 70+ take the longest and also have less favorable outcomes. There are various reasons for this, but one has to assume that some of it has to do with compliance, bone structure/posture, and possibly pain tolerance.