Frozen shoulder or frozen shoulder refers to a group of joint disorders that restrict the mobility of the shoulder joint. This is where the term frozen shoulder comes from.
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Brief overview:
- What is frozen shoulder? Several types of painful joint disorders of the shoulder are summarized under frozen shoulder or frozen shoulder. The mobility of the shoulder is restricted.
- Cause: Inflammation following an injury or wear and tear of the bones, tendons, ligaments, muscles or bursa can lead to frozen shoulder.
- Symptoms: Shoulder pain and limited mobility of the shoulder are the main symptoms. The shoulder may also be swollen and warm.
- Diagnosis: During a physical examination, the doctor will recognize when pain occurs and when movement triggers pain. CT, MRI and ultrasound can then confirm the diagnosis.
- Treatment: Mild forms are treated with medication and physiotherapy. Severe forms require surgical intervention.
- Prognosis: If treatment is started early, the prognosis is very good. However, if left untreated, shoulder arthrosis can occur, causing the joint structures to gradually degenerate.
Article overview
Around 2 to 5 percent of the population suffer from shoulder pain. Frozen shoulder syndrome is most likely to occur in people over the age of 40. Women are affected slightly more often than men.
Causes and risk factors for frozen shoulder
The shoulder consists of various structures that ensure shoulder mobility, including
- the shoulder joint,
- ligaments and tendons and
- muscles.
These structures work closely together. If individual structures are impaired, this can affect the mobility of the shoulder.
A frozen shoulder can be caused by, among other things
- Accidents,
- injuries,
- operations,
- shoulder osteoarthritis (cartilage wear in the joint) or
- shoulder impingement
can be the cause. These cases are referred to as secondary frozen shoulder. Those affected by shoulder pain usually adopt a resting posture and no longer move the shoulder sufficiently. This immobilization promotes the development of frozen shoulder.
Shoulder pain that is accompanied by an increasing inability to move is referred to as frozen shoulder © yodiyim / Fotolia
In rare cases, frozen shoulder develops independently, i.e. without prior illness, injury or surgery. This is referred to as a primary frozen shoulder. The causes are then usually unknown.
Possible risk factors that can promote the development of primary frozen shoulder are hormonal disorders or changes. Such changes can be caused by thyroid disorders or during the menopause.
In addition, there are also
- Metabolic diseases such as diabetes mellitus or hyperlipidemia
- genetic predispositions
are also suspected of causing frozen shoulder.
In some cases, calcium is deposited in the tendons of the shoulder, in which case it is also referred to as a calcified shoulder.
Symptoms and progression of frozen shoulder
Typical symptoms of frozen shoulder are shoulder pain and restricted shoulder movement. The shoulder may also be swollen and warm.
The symptoms usually only occur in one shoulder, but one in three sufferers also experience symptoms in both shoulders.
However, a primary frozen shoulder does not develop overnight. The development takes months or even years and is characterized by three stages:
- Stage I ("freezing phase"): Increasing, sometimes sudden onset of severe pain and also the first restrictions in movement occur.
- Stage II (plateau phase): Restriction of movement dominates. The shoulder stiffness is now fully pronounced, the pain decreases.
- Stage III ("thawing phase"): The movement restrictions improve. The pain has almost disappeared.
Diagnosis of frozen shoulder
To diagnose frozen shoulder, the doctor first takes a detailed medical history . As part of this, he asks about the following, for example
- symptoms,
- other illnesses and
- injuries or accidents.
The physical examination can trigger pain and determine movement restrictions.
If necessary, imaging examinations such as
- Ultrasound (sonography),
- CT (computer tomography),
- MRI (magnetic resonance imaging).
This enables the doctor to detect or rule out damage to the structures involved in the joint. These examinations also serve as preparation for an operation.
Treatment of frozen shoulder
The treatment of frozen shoulder depends on
- the stage of the disease,
- the cause,
- the duration and severity of the symptoms.
In the early stages in particular, treatment is conservative. This includes anti-inflammatory and pain-relieving medication and physiotherapy exercises. However, the damaged joint must not be overloaded.
Conservative treatment does not always lead to an improvement in symptoms. In this case, only shoulder surgery can eliminate the cause of the condition. Surgery is also used for anatomical causes of a stiff shoulder.
The surgical procedure can usually be performed using minimally invasive techniques(shoulder arthroscopy). The video shows the shoulder arthroscopy procedure:
Prognosis of frozen shoulder
If the shoulder joint inflammation is treated early, it usually responds very well to therapy.
However, if treatment is started late, complications such as shoulder arthrosis can occur. This makes treatment protracted.
Sometimes, however, relapses (recurrences) can also occur.
Prevention of frozen shoulder
Frozen shoulder cannot generally be prevented. However, to prevent the condition from worsening, you should consult a doctor as soon as the first symptoms occur.