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

Looking For A Frozen Shoulder Cure? Start Here

I'm very familiar with the pain and dysfunction caused by adhesive capsulitis and the desparation to find a frozen shoulder cure. In fact in 1998 after rotator cuff surgery I developed this condition despite practicing as a physical therapist. I was about one year out from getting my license and this was the last thing I expected to develop. This actually turned out to be a good thing as it has allowed me to "connect" with my patients who have this diagnosis. It also has motivated me to discover what works and what doesn't by trying various treatments and techniques on myself.

Frozen shoulder syndrome or FSS is a condition marked by stages of progressive pain and stiffness in the shoulder which can take months or even years to recover. A cure implies a short course of treatment or single intervention which would eliminate the physiological process of frozen shoulder syndrome or "adhesive capsulitis". A "cure" would also imply an immediate halt to the progression of the stages of FSS. None of the current treatments available for frozen shoulder have met the above criteria, although in my experience a well planned and developed program can hasten the end results a person with this condition desires, that is, return of normal and pain free range of motion. Therefore the term "cure" for the purpose of this article refers to reduction of pain and return of function.

Studies have shown while there is no one single "frozen shoulder cure", there are treatments available to reduce pain and speed return of function when otherwise just resting the affected limb will do little to no good.

WHERE TO BEGIN?

* Start with an accurate diagnosis by a qualified physician, preferably one who specializes in treatments of frozen shoulder or conditions of the upper extremity

* Educate yourself about this condition and try to determine what stage you are in. Education is key in helping you maintain the motivation to continue and to choose the right program or treatment

* Choose programs that are multi-faceted in approach and treat both the painful symptoms and return of function

* Good programs are ones designed by a licensed professional and provide follow up support or answers to your questions

An accurate diagnosis prevents unnecessary treatments, wasted time and carries with it the benefit of finally knowing why your shoulder hurts. I have seen numerous clients who self-diagnosed a frozen shoulder, put themselves through unnecessary injections and exercise only to find that the problem was coming from the neck (yes, you can have pain in the shoulder which is coming from a compressed nerve in the neck).

Education begins by asking questions. Never take your doctor's word or anyone's word for that matter as the "gospel" without probing a little further and asking what that strange word the doctor said means, and/or why you are getting the treatment you are getting. If you are seeing a doctor you are unfamiliar with, it doesn't hurt to as what his/her medical specialty is (if it's not obvious). In these days of Medicare cuts and changes the specialists are starting to branch out and see more diagnoses outside their specialty. If you decide to educate yourself via the internet, make sure you are familiar with the medical terminology within your diagnosis or otherwise your frozen shoulder "cure" you find on the web can turn out to be harmful or ineffective.

Frozen-Shoulder-Help.Info is the closest thing to a "frozen shoulder cure" available. This is a comprehensive program specifically designed for this condition and focuses on returning function and reducing pain. "What Is A Frozen Shoulder Cure" originally posted on EzineArticles by this author.

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.

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.

Frozen Shoulder Exercise - Don't Waste Your Time

I really believe what the above title says - "Don't waste your time", however not in the way you probably thought this post was about. Frozen shoulder exercise is most effective when started early, not late in the recovery process. Therefore there are many reasons not to waste time in starting the rehabilitation process.

Don't waste your time waiting to see if it will heal. Once your doctor has said you have adhesive capsulitis, be proactive and begin immediately the exercises your doctor or therapist has outlined for you. Just a month of inactivity could mean months of added rehab.

Don't waste your time trying to find the "instant frozen shoulder miracle" - it doesn't exist. I know this from treating hundreds of shoulder patient's. The ones who believe rest and denial are the road to recovery often end up with a dysfunctional arm for years. In other words, be careful of "snake oil" salesmen.

Don't waste your time going from doctor to doctor trying to make sure that you really have adhesive capsulitis. If the signs and symptoms are there, treat it so and avoid potential job ending or hobby ending dysfunction. Take the bull by the horns, so to speak.

Although painkillers have there place in the rehab process, don't waste your time thinking "just one more" hydrocodone pill will do the trick. Although this condition is very painful (I know because I've had it), I don't know of anyone who has had to go to the hospital because of the symptoms.

Don't waste your time performing the same frozen shoulder exercises over and over. Your shoulder will respond more readily to a variety of movements in different planes of motion. If you are having a hard time, consult with your therapist or doctor for different techniques to improve your shoulder pain and range of motion.

Don't be a party to the time wasters out there who think they have the best advice in telling you that "it's no use" or "no matter what you do it won't get better". Each person diagnosed with this condition responds differently in different time frames. One person may have great results with his therapy program while another may tell you it has been a poor experience. However my experience has shown me that most of the patients who have a less than desired outcome have neglected to follow a strict plan of action for getting rid of there shoulder pain and stiffness. The ones who begin a frozen shoulder exercise plan early will reap the rewards of a once again painless shoulder

Exercises For Frozen Shoulder Treatment

Some of the best exercises for frozen shoulder treatment actually involve two people, you and a partner. These do not involve the other person "yanking" or "cranking" on your arm (which is a no no) so try to be in a relaxed state when following these suggestions. Moist heat also helps just prior to beginning these exercises. As always, it is recommended that any exercise is done under the guide of your physician or physical therapist, therefore you are on your own if attempting these without the above:

• Lie supine (on your back) and have your partner (standing) hold onto your wrist with your arm extended fully at the elbow and your shoulder at about 45-60 degrees. Your partner then will gently shake your arm, almost at a vibrating pace, for 30 seconds to a minute. This helps to relax tense and guarded muscles.
• Have your partner then gently pull your arm (while you relax) first straight down towards the direction of your toes. Hold this for about 20-30 seconds. Next, have them pull out to your side and hold the same amount of time. After that, have them pull in an upward direction and hold 30 seconds. Repeat this sequence 3-4 times before moving on to the next exercise.
• While lying on your back, have your partner stand facing towards the direction of your head. Your shoulder should be at about 45 degrees away from your body with your elbow bent at 90 degrees. Your hand should be pointing towards the ceiling if possible. They should then support your elbow underneath with the hand closest to your body and hold your wrist with the other hand. While relaxed, have them gently push your hand backwards toward your head until a mild stretch is felt. Hold this stretch at least 30 seconds then relax. Repeat several times.

The above frozen shoulder rehab exercises are great preliminary warm-ups for further stretching on your own. For maximum effectiveness, these should be done 3-4 times per day if possible, particularly if you are in the "freezing" stage of a frozen shoulder.

Frozen Shoulder Trigger Points

Trigger points are painful areas of hypersensitivity with muscle tissue. They often accompany a frozen shoulder and make the condition even more painful than it already is. These trigger points go through flare-up phases and can feel like your neck muscles or muscles of the upper back are tied in knots. There is relief for those trigger points - namely "trigger point massage". This involves using a hard, knobby instrument or one's knuckles to apply deep tissue pressure over the hypersensitive area. This will "release" the trigger point if done with enough force over time. Most people do not have the strength or endurance to perform this type of massage on another. The answer to this problem is the "knobber" which is a commercially available product designed to take the effort out of giving a trigger point massage. An excellent trigger point massage can be performed independently with a "Theracane". This ingenious device is shaped like a candy cane with knobby projections coming out from the side. This in conjunction with frozen shoulder exercise can make life much more bearable during a frozen shoulder.

A theracane is described and can be purchased at Frozen Shoulder Therapy on Squidoo.com

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.

Frozen Shoulder Manipulation

If you've gotten to the point where you feel a frozen shoulder manipulation is your only course of action, then there are some points to consider:

• If you have not yet reached the "frozen" stage of Adhesive Capsulitis within a full year your doctor may recommend a manipulation under anesthesia.
• There is a 70-75% success rate (success defined as any improvement in ROM, not necessarily function)
• This success rate is less likely with diabetics
• There is a small but still present risk of sustaining a fracture during the procedure (best research shows this as small as 2%)
• Most manipulations are done as outpatient and you will need someone to drive you home after the procedure
• There is to be an expected increase in pain for several days following a frozen shoulder manipulation. This is due to soft tissue trauma, increased swelling, and induced inflammation in the shoulder due to the procedure causing micro tears in the joint capsule
• Physical Therapy or frozen shoulder exercise is generally prescribed for 3-4 months following a manipulation
• There is risk of infection following injection into the shoulder joint

Obviously a manipulation should be a last resort and preferably should be considered only after a second opinion. Once the manipulation is performed, physical therapy should be initiated as early as day 1 following the procedure as the shoulder joint will stiffen up quickly and render the procedure useless if early movement is not performed.

The best course of action is always a conservative approach using frozen shoulder exercise versus a frozen shoulder manipulation. There are many treatment programs specific to treating a frozen shoulder which are effective in returning functional range of motion and reducing pain.

Is My Shoulder Frozen?

As a physical therapist I'm often asked how to tell if someone's shoulder pain and stiffness means they are getting (or have) a frozen shoulder. A frozen shoulder (or Adhesive Capsulitis) is a specific condition typically involving adhesions which form around the joint capsule. The joint capsule is simply a fibrous structure encasing shoulder joint.

This capsule can shrink with disuse of the shoulder, such as after long term immobilization after a fracture (called adaptive shortening) causing increased stiffness and pain with range of motion. This is not a true presentation of primary frozen shoulder. Primary frozen shoulder seems to appear without cause or warning, often presenting as painful shoulder motion at first, then progressing to increased stiffness.

The treatment of these two presentations differ (at least they should), because the type of exercise used for treating a primary frozen shoulder is different than treating simple adaptive shortening. In primary frozen shoulder the first motion lost is external rotation (reach back and touch the palm of your hand to the back of your head), followed by loss of abduction (raising your arm out to the side), then flexion (forward elevation of the arm overhead), and finally internal rotation (reach behind your back as if fastening a bra (or threading your belt if you're a male).

In addition, a primary frozen shoulder will be painful at night without movement of the arm/shoulder. In contrast, adaptive shortening does not follow this pattern of loss of motion as any direction can be stiff/painful. Also with adaptive shortening the shoulder does not typically hurt at rest.

So if or a love on is asking "Is my shoulder frozen" the you can follow the above descriptions to better decide which condition you may have. In any case you should get a formal diagnosis from a physician and seek treatment from qualified professionals. It's important to get specific treatment for frozen shoulder syndrome as the wrong exercise can actually delay healing and prolong symptoms.

An excellent program for treating frozen shoulder is designed by a physical therapist and covers specific exercises and the best frozen shoulder exercise strategies for this painful condition.

Supercharge Your Frozen Shoulder Exercise

Most frozen shoulder exercise programs are performed in routines 3 times a day. However if the patient is not getting sufficient ROM gains then I would recommend a different attack. Try 8-10 times a day, however with significantly shorter exercise sessions. This allows the shoulder not to tighten up between exercises and often makes the exercise less painful and with less soreness afterwards. Always remember to warm the shoulder with moist heat prior to each session and ice after each session, particularly if you are prone to inflammation. The heat should be applied for approximately 20 minutes for maximum heat depth with a temperature that is very warm but of course not enough to burn the skin. Ice on the other hand should be applied for 15 minutes at a time. Gel packs are ideal as they conform to the shoulder nicely. Completely rest the shoulder in between these frequent but short sessions. The best frozen shoulder exercise will not do any good if not performed correctly.
For more information on excellent programs visit my web page on reviews of frozen shoulder exercise programs