orthopedics

  Frozen shoulder, or its other term, adhesive capsulitis, is a relatively common condition affecting typically women between ages of 40 and 60, that comes on for no good reason. Frozen shoulder/Kold skulder is classically described in three phases. The first phase is known as the freezing phase. Clinically patients complain primarily of pain at that point, and not so much stiffness. The second phase is the frozen phase, and at that point, the pain actually often diminishes, but the shoulder can be markedly stiff. Patients will eventually enter the thawing phase, and in many cases, frozen shoulder or adhesive capsulitis is a self-limiting condition, meaning that ultimately it does get better, sometimes entirely on its own. But that process can sometimes take up to two years or more, but if you can make that diagnosis early, which can be tough, you may be able to avoid that process of stiffness. I would recommend as a first step seeing your primary care doctor and discussing the problem, and at that point, the next step may be the referral to physical therapy or even evaluation by an orthopedist. At the first visit, a patient can expect, first of all, and perhaps most importantly, a thorough history. That's critical to making an accurate diagnosis. Secondly is a thorough physical examination of the shoulder. And generally, between the past and the physical examination, you should have a good sense of what's going on. So regarding treatment, for patients who are in that initial freezing phase, inflammatory phase, or having a lot of pain, anti-inflammatory medication can be helpful. Gentle, and I think the key is gentle physical therapy, either under the direction of a skilled physical therapist or sometimes even just self-directed at home, can be beneficial to help maintain range of motion. We also routinely employ the use of intra-articular corticosteroid injections, which is an injection of corticosteroid that's done directly into the shoulder joint, so if the patient is not getting better over a specified period, they may be a candidate for some intervention. A surgical procedure is performed, it's called an arthroscopic capsular release, so the process's done arthroscopically through small incisions, and what's done is under arthroscopic visualization, the stiff and fibrotic capsule is cut and released. Bottom line is you have shoulder pain, and it's affecting your daily living, I think it's time to get checked out, initially, perhaps by your primary care physician, but indeed if the pain's persisting and it seems like something is going on and it's not just getting better on its own, it may be time to get checked out by orthopedics.