It is important to know which phases you are in!! because the management will be different.
This is Yohei Takada from FuncPhysio Physical Therapy. Among various conditions I see in my office, cases of Frozen Shoulder have increased over the past few years. Japanese patients with the complaint outnumber American patients by far. 20-30% (some say nearly 60%) of Japanese people suffer from the condition, while in America it is only 2-5%. We will set aside the reasoning behind the difference for now, and discuss the cause, prognosis, and treatment for frozen shoulder.
First of all, there is no proven cause of frozen shoulder. Many patients experience pain so severe that they cannot sleep or dress themselves, however, the treatment is challenging because of its unknown etiology and slow recovery. Risk factors include age (40s to 60s), female gender, and diabetes. It is known that the symptoms are often on the non-dominant side, which also has no scientific explanation.
From my experience, I found a trend that a patient with a frozen shoulder put constant stress on their shoulder joints, collar bone, rib cage, thoracic spine, and cervical spine. Frequent exercising and stretching cannot prevent frozen shoulder but rather put stress on these areas and cause inflammation. Difficulty raising an arm, or a clicking sound on the shoulder is a clear warning sign. I believe an accumulated stress and trigger factors like hormonal imbalance lead to an inflammation, which ultimately turns to a frozen shoulder. It is important to diagnose frozen shoulder in an early stage in order to provide an effective treatment.
Frozen shoulder has four phases: Inflammatory phase, freezing phase, frozen phase, and thawing phase. Although every patient goes through the same process, the recovery speed and aftereffects depend on an individual. The majority of patients recover after a year, while some take 3 to 4 years. Some suffer from partial shoulder immobility even after the pain is gone.
It is important to start treatment in the early inflammatory phase. Successful prevention of further inflammation determines the severity and recovery speed. However, many patients wait at least a year or two before seeking medical help. Those are often neglected or received improper care during the early phase, and their condition worsened.
Inflammation and pain from frozen shoulder, especially in the early phase, are very severe. The symptoms are often treated with pain relievers and anti-inflammatory medications. When medications are not enough, I ask the orthopedic physicians to give steroid injections. Even this does not work sometimes, giving medical practitioners headaches. I believe that any condition should be treated by restoring body coordination and recovering an effective function. Therefore, steroid injections for frozen shoulders are the last resort for treating inflammation, since repetitive injections can damage tissues around the area.
We recently installed the latest M6 laser machine in our office. It has anti-inflammatory, pain relief, and tissue recovery effects with no side effects. This is ideal for treating frozen shoulder, both in the early and late phases. Since different approach works for different individuals, it is important for medical practitioners to collaborate and find the right treatment. In addition, excessive stretching and movement during the inflammation phase can worsen the condition.
What comes after the torturous inflammatory phase is shoulder immobility. The shoulder joints and surrounding tissues harden due to limited use from pain as well as collagen thickening from inflammation. During this phase, physical therapists use massage, stretching, and joint mobilization techniques to slowly restore mobility. Although some pain is associated with the procedure, it saves your shoulder from permanent loss of mobility and prevents a recurrence.
Unfortunately, many people are still unaware of the importance of early diagnosis and treatment of the frozen shoulder. Since shoulder pain and stiffness are so common, and its progress being slow, they tend to think it is just an age-associated thing. Some mistake the symptoms for other conditions. Delayed diagnosis or misdiagnosis, abusing of the joints, and exercising can worsen the inflammation, causing serious damage.
Physical therapy is not an instant cure. However, our approach can help diagnose the condition, provide appropriate treatment for each phase, improve mobility, and prevent a recurrence. If you feel anything around your shoulder, please do not hesitate to plan a visit. One again, early diagnosis is the key!