How To Treat A Frozen Shoulder

By Datuk Dr Badrul Shah Badaruddin

Dear Readers: An Audio version of this article is available below.

Kuala Lumpur, July 24: By now, most Malaysians are probably well-adjusted to the whole working from home routine. Some parts of it may be enjoyable but other parts like aches and pain from a poorly set-up workspace – not so much. At ALTY Orthopaedic Hospital, we saw that shoulder pain is a common occurrence among patients, especially now where people are working from home and spending long hours in front of their devices.
The abnormal posture when someone crouches over a laptop for several hours each day can lead to shoulder injuries and pain. In addition, Malaysians are also living an increasingly sedentary lifestyle – especially during the pandemic that make being active a challenge. Our muscles become flaccid with limited movement, and this means even regular activities like opening a door or stretching to reach something might lead to muscle strain eventually leading to inflammation, or worse – a frozen shoulder.

What causes Frozen Shoulder

Frozen shoulder, also known as ‘adhesive capsulitis,’ is a condition in which the movement of the shoulder becomes limited, characterised by stiffness and pain in the shoulder joint. Frozen shoulder occurs when the capsule that surrounds the normal shoulder joint becomes thick, stiff, and inflamed. 
Other factors that can lead to frozen shoulders include a sudden jerk of the shoulder or awkward sleeping position which could cause tendonitis. Tendonitis is an inflammation around the tendon that may spread to the capsule and cause it to be inflamed and stiff – resulting in a frozen shoulder. 
Sometimes inflammation around the capsule that causes frozen shoulders can also occur as an acute response to viral fever or flu such as COVID-19 infection. It is quite common to experience joint inflammation when our body’s immune system is tackling the infections. This condition is known as viral arthralgia, and it usually disappears on its own without any lasting effects. Although in rare cases, the symptoms can prolong. 
The process of getting a frozen shoulder usually begins with inflammation. Inflammation causes pain that is worse with movement and limits the shoulder’s range of motion. If the inflammation around the capsule is not treated properly, the pain and stiffness may develop into a chronic state. Therefore, any shoulder pain is worth getting looked at soon before something simple to deal with develops into something a lot harder, which may need surgery.

How to reduce inflammation? 

Below are some ways to help reduce inflammation and keep it in check: 

  • Muscle movement: Regular exercise is an excellent way to prevent inflammation. According to research published in the journal Brain, Behavior and Immunity, one 20-minute session of moderate exercise can stimulate the immune system, producing an anti-inflammatory cellular response.
  • Heat or cold therapy: Heat can help to soothe stiff joints and relax muscles as it improves circulation and blood to flow to a particular area. While cold helps to reduce inflammation and swelling that causes pain, especially around a joint or a tendon. For basic heat therapy, you could use small heated gel packs, a hot water bottle, or a warm bath. For cold therapy, a water bottle filled with cold water, a pad cooled in the freezer, or cool water can be used.
  • Anti-inflammatory medicines: If the pain is causing a lot of discomfort, you could also speak with your physician for prescription drugs that can help to reduce your inflammation.  

Treatment for Frozen Shoulder

The treatment for a frozen shoulder is focused on relieving pain and restoring the shoulder’s normal range of motion. Below are some of the common treatments that we’d recommend for patients who is experiencing frozen shoulder:

  • Physiotherapy: Physical therapy is the mainstay of treatment for frozen shoulders. A physical therapist can provide exercises to help restore the shoulder’s range of motion and mobility. They may also prescribe anti-inflammatory drugs depending on the conditions. If the pain doesn’t subside for three to six months, patients may be given corticosteroids (anti-inflammatory drug) directly to the capsule. 
  • Ultrasound treatment: An alternate treatment for frozen shoulder, ultrasound improves blood circulation and dilates the vessels. It can also help with improving the ability of the shoulder stretch and quicken the healing process by reducing pain as well as increasing flexibility and range of motion.
  • Closed manipulation of the joint: A non-operative procedure done under full anaesthesia where the doctor will move the arm at the shoulder joint to break up the adhesions and loosen the stiff joints, resulting in improved range-of-motion. Ninety five per cent of patients will show immediate improvement and in many cases, they will be completely cured in this instance. 
  • Surgical treatment: if all the conservative treatment fails, minimally invasive arthroscopic procedure may be the definitive treatment. It involves a keyhole surgery to release the adhesive capsulitis of the shoulder joint and only need one or two days of hospitalisation.

Shoulder pain can interfere with so much in your life, from work and play to sleeping. It’s important to get your shoulder checked if your pain doesn’t go away because with some injuries, such as frozen shoulders, the longer you wait for medical help, the harder it can be to treat the problem. If you have shoulder pain or swelling and it is not going away, then speak with your doctor about your diagnosis and treatment options.

About the Author: Datuk Dr Badrul Shah Badaruddin (pictured) is the Consultant Orthopaedic, Arthritis and Sports Surgeon from ALTY Orthopedic Hospital in Kuala Lumpur, Malaysia.

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