Despite long-time awareness of this painful condition known as frozen shoulder, we still don’t fully clearly understand its pathology and, in many cases, have no idea what causes it.
What Is Frozen Shoulder?
Most Palmdale Physical Therapist say that frozen shoulder or adhesive capsulitis is a condition that limits the range of motion of the shoulder. The shoulder—similar to the knee, elbow, and hip—is a joint.
The shoulder joint (glenohumeral joint) is developed of a capsule filled with ligaments which attach the shoulder bones together. When this joint becomes inflamed, as happens with frozen shoulder, it becomes pretty painful to move your shoulder.
Results from biopsy says that frozen shoulder begins as a chronic inflammatory condition followed by fibrosis and fibroblast proliferation. This proliferation is likely immunomodulated.
On a related note, the pathology of frozen shoulder is very similar to Dupuytren’s contracture, another fibrotic condition which affects the fingers.
Frozen shoulder is usually diagnosed by a physician after a physical exam. Often, diagnostic imaging modalities such as an x-ray provide a small amount of confirmation of this diagnosis although MRI and ultrasound can show soft tissue changes like ligament thickening.
Frozen shoulder affects between 2 percent and 5 percent of all people. Although in most people, the condition eventually remits, this debilitating and painful condition is the bane of primary care physicians and specialists because it’s notoriously difficult to treat.
Risk Factors for Frozen Shoulder
In a majority of individuals, Palmdale Physical Therapist will tell you that frozen shoulder is idiopathic. (Idiopathic is medical jargonese referring to unknown cause). Regardless, specific risk factors likely play a pivotal role in this condition including the following:
- shoulder injury
- shoulder surgery
- cervical disease of the neck
- thyroid problems
- open heart surgery
Differential Diagnosis for Frozen Shoulder
Because the diagnosis of frozen shoulder mainly relies on clinical exam findings, differential diagnoses or other shoulder pathology must be thought of. Here is a list of diseases that can develop from frozen shoulder:
- cancer (Pancoast tumor)
- cervical disk disease (cervical spondylosis or “arthritis of the neck”)
- brachial neuritis
- Milwaukee shoulder
- rotator-cuff tendinopathy
- avascular necrosis of the humeral head
Treatment for Frozen Shoulder
With respect to treatment, our Palmdale Physical Therapist say it’s essential to first diagnose and treat any underlying risk factors for frozen shoulders such as diabetes and thyroid disease.