FROZEN SHOULDER: CAUSES, SYMPTOMS, DIAGNOSIS AND TREATMENT

Published At: 14 January 2020 , 11:48 AM

The most famous joint of the upper part of the human skeleton is the shoulder. It formed by the bones of the shoulder, shoulder blades, and collarbone, which covered with a protective shell filled with fluid. This joint capsule, consisting mainly of ligaments, provides bones with stability and prevents friction between themselves. Its damage leads patients to the CONSTANT Clinic in Yaroslavl with complaints of decreased mobility and severe shoulder pain. Capsulitis, which is also called the "frozen shoulder", affects people mostly middle-aged and older (40-60 years), women - more often than men.

THE ESSENCE OF THE DISEASE AND THE CAUSES THAT CAUSE IT

The vernacular name of the ailment speaks of the first sensation in the shoulder joint - frozen, that is, the stiffness of the movements of the sore arm. The mobility of the shoulder-shoulder joint limited due to the defeat of the capsule, which is characterized by its compaction, inflammation of the lining cavity, thickening, and extension of the synovial membrane. These violations minimize the possibility of raising in the frontal direction and abduction of the arm, in severe cases, deliver physical pain with each action. The disease occurs suddenly and gradually progresses.

REASONS CAUSING THE DISEASE

Mechanical injuries Fresh bruises, fractures, and even old injuries in this area are factors that directly affect the onset of the disease.

Uneven load on the spine and shoulder Work involving an extended stay in stillness, in an uncomfortable position, with the frequent raising of the hands up disrupts the blood circulation in the tissues.

Violation of metabolic and metabolic processes in the body Oncology, diabetes mellitus due to the constant intake of insulin, the changing hormonal background of a woman during menopause disrupt healthy metabolism and metabolism.

The presence of concomitant diseases, including Chronic hereditary pathologies of blood circulation, respiratory, nervous, cardiovascular systems, periarthritis of the other joint, and osteochondrosis of the cervical spine, often become the cause of capsulitis.

RISK FACTORS

Low physical activity The lack of sufficient physical activity for the shoulder muscles can cause pathological processes in the cartilage tissues.

Bad habits The adverse effects of alcohol and nicotine on the body can increase the likelihood of developing pathology.

A common viral infection, hypothermia, or a small injury to the upper limb, which not always sought for medical help, can lead to inflammation. If characteristic symptoms of a frozen shoulder appear, consult a doctor immediately! If untimely or incorrectly begin to treat capsulitis, it can lead to severe complications. With the pathological process launched, it is possible to lose the functionality of the hand for life and remain disabled.

SYMPTOMS OF INFLAMMATION OF THE CAPSULE OF THE SHOULDER JOINT

The main manifestations characterizing the frozen state of the joint capsule are two:

  1. reduction in the range of motion, progressing to the complete impossibility of moving the affected arm;
  2. joint pain when raising and turning the arm, which over time complement pain in the neck and spine, numbness of the hand and awkwardness in the fingers, intensifying as the pathology develops.

Symptoms may vary slightly depending on the cause and stage of the disease. If the condition is not associated with the injuries suffered, a less active arm is usually affected. Discomfort and pain at night are more intense than during the day. Without timely medical assistance, the patient has an increase in the symptoms of a "frozen shoulder," which will be more challenging to get rid of than at the initial stage of the inflammatory process. To determine the degree of development of pathology, a thorough medical examination is necessary.

CAPSULITIS FORMS AND STAGES OF DEVELOPMENT

Inflammation of the ligament-tendon apparatus of the shoulder joint has two forms:

Post-traumatic Idiopathic (adhesive)

It arises as a result of bone fracture, tendon rupture, other injuries, or surgical interventions in the shoulder area when the limitation of mobility is natural. The pathological process, in this case, develops as a result of insufficient or ineffective rehabilitation therapy. The problem arises spontaneously, developing against the background of various pathologies of non-traumatic origin (diabetes mellitus, oncology, nervous system diseases, circulatory organs, heart attacks, strokes, heart surgery, inflammation of the joint, and cartilage tissues). At the same time, the joint capsule decreases markedly in volume.

The disease, as practice shows, can last from several months to 3 years, passing three stages of development:

  1. The gradually lost mobility of the shoulder causes discomfort and mild pain, mainly at night, after the motor activity of the arms and shoulder girdle. This phase can last from 1 to 9 months. Fixing the arm can improve well-being with an elastic bandage.
  2. At this stage, the pathology is seriously progressing. It is difficult for the patient to move his hand without experiencing pain. The duration of the phase depends on the effectiveness of the treatment. It can lead to a transition to the stage of recovery or delay the process for many years.
  3. An increase in symptoms characterizes the last stage. Soreness in the shoulder extends to the neck and spine. In the absence of treatment, the limited movement reaches a complete loss of limb functionality.

DIAGNOSTICS

To take timely measures to eliminate the "frozen shoulder," it is necessary to diagnose it as soon as possible. The differential diagnosis complex includes:

compilation of a clinical picture based on medical examination and patient complaints;

arthrography to detect a decrease in the volume of the joint cavity;

X-ray and ultrasound examination, in some cases - magnetic resonance or computed tomography;

blood test for the presence of ESR protein in it.

The detection of pathology in the initial stage will allow us to cure it faster and more efficiently.

TREATMENT

The goal of therapy is to rid patients of pain in the shoulder joint and restore the full functionality of the arm. Depending on the complexity of the case, this may take either a month or several years.