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.

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

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

Topical Rubs Can Give Frozen Shoulder Pain Relief

While it's true that topical rubs such as Icy Hot, Biofreeze, etc... only provide short-term relief for frozen shoulder pain sufferers, they do have their place in the treatment of adhesive capsulitis, provided the patient has a targeted program and only uses it as an adjunct to treatment.

These or similar rubs work basically by irritating the skin, giving the recipient a warming sensation. This warming sensation is then translated by the brain into pain relief. This is known as the "pain gate" phenomenon and basically means that certain pain pathways in the peripheral nervous system can only process a certain amount of pain signals at any given time. After that, the "gate" is shut off to further pain signals in that pathway.

Think of it this way, if you have a headache and someone suddenly stomps on your toe, your headache is suddenly gone and the focus of pain is now on your freshly stomped toe. Same thing with topical rubs: Shoulder pain present? Rub in Biofreeze... ointment irritates the skin and therefore pushing a large amount of "irritant" pain signals to the brain, overriding the shoulder pain signals, and subsequently PAIN RELIEF!

Now there are certain rubs that are more effective at generating the amount of "heat" than others. A little research and experimentation will help you decide although I have found Biofreeze to be very effective for patients.

Even the best frozen shoulder exercise programs needs a boost, and often the answer can be found in the wide variety of ointments available on the market today. Don't fall for pitches that state a particular product "goes deeper" than another product, as this simply isn't true. NO topical ointment can penetrate past the dermal layers into the muscle, and thank GOD for this because then you're talking some SERIOUS pain. Therefore do not consider a higher cost product necessarily more effective.

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.

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.

frozen shoulder cure?

As a physical therapist I'm often asked if injections "cure" a frozen shoulder. I almost always begin by saying "no" and then proceed to tell the patient that an injection (typically and anti-inflammatory agent) MAY give some temporary relief, but is not the answer to their stiffness and pain.

In fact, an injection with a corticosteriod, if given multiple times, can cause way more problems than it solves. Repeat steroid injections can weaken tissues and bone and may actually put the recipient at further risk.

Now if the pain is unbearable I'm not totally against this type of injection, but would rather educate the patient on the benefits of specific frozen shoulder exercise and treatment to reduce the amount of pain and stiffness.

You see, when a frozen shoulder develops the first thing a patient does is stop moving the shoulder as much. This causes "adaptive shortening" of the joint capsule surrounding the crucial rotator cuff. When this happens the cuff muscles do not have enough "room" to perform their function and end up getting iritated due to friction againt the capsule wall.

Guess what happens then? MORE pain and stiffness. The best solution to relieving frozen shoulder pain is with a specifically targeted exercise program designed by a healthcare professional that has experience in this area. The gradual stretching of capsular tissue and release of adhesions is the true "cure" for a frozen shoulder.

Frozen Shoulder Treament After Cuff Surgery

This particular patient has developed a frozen shoulder (secondary) 4 weeks after undergoing cuff surgery. She came to physical therapy 1 week after her surgery and did well to begin with. I've discovered her main problem to be her exercise frequency as she is inconsistent. I was able to perform P/A glides with her and gained 20 or so degrees today. I reviewed her posture (very important) and her exercise frequency - focused on performing stretches in 10 (yes 10) brief sessions over the next few days. Believe it or not I find this type of frequency with my patients to be very helpful. She understands there is no frozen shoulder "cure" and that consistency is key in getting return of function. Here's hoping this session was successful! Also reviewed the most efficient frozen shoulder exercise.