Physical Therapy and Rehabilitation Specialist Associate Professor Ahmet İnanır gave important information on the subject. Some pains are very persistent and negatively affect quality of life. In particular, joint pain and limitations can make even daily activities impossible. One of these diseases is frozen shoulder syndrome. Frozen shoulder is a serious health problem that can severely impair quality of life and is accompanied by progressive limitation and pain.
What is Frozen Shoulder Syndrome?
It is believed to be inflammation of the joint capsule and subsequent fibrosis. There is thickening or shrinking of the ligaments forming the capsule around the shoulder joint and the joint capsule.
What are the symptoms?
The complaints in the first stage of the disease are often similar to the 'impingement syndrome'. There is usually an insidious onset of pain. Following the pain, limitation of movement in the shoulder begins. Nocturnal and resting pain is common in the early stages. Pain that does not go away even while resting, disrupting and complicating sleep at night, shoulder pain throughout the day, limitation of shoulder movements, limitation of normal daily movements, inability to raise or rotate the arm from a certain point can be seen.
Who is it most common?
Although it most commonly affects women between the ages of 35 and 70, it can also be seen in men.
What are the triggering factors?
Although its etiology is not known exactly, it is associated with diabetes, autoimmune diseases, thyroid diseases, Parkinson's disease, heart diseases, stroke, chronic lung disease, Dupuytren's contracture, shoulder calcification and breast cancer, as well as trauma, surgical procedures and prolonged immobility.
How is it diagnosed?
Diagnosis is made by medical history, clinical examination, radiological imaging and exclusion of other shoulder pathologies. Often there is an insidious onset of pain; Following this pain, limitation of movement in the shoulder begins. Nocturnal and rest pain is common in the early stages. In frozen shoulder, most movements from the scapulothoracic joint are also affected. There is no specific examination test for diagnosis. Magnetic resonance (MR) and Ultrasound are used to detect other pathologies such as rotator cuff tears. MR arthrography is used to show capsule thickness and reduction in joint volume.
What is the treatment?
Although there is a possibility that the collapsed shoulder syndrome will go away on its own, the surest solution is medical treatment. Physical therapy is primarily preferred in the treatment of frozen shoulder. The aim of the treatments is to loosen the hard shoulder joint capsule and to control the pain, which is one of the most important complaints of the patients, and to regain the movement and strength of the joint. Within the scope of physical therapy, in addition to classical physical therapy methods, methods such as manual therapy, prolotherapy, neural therapy, intra-articular injections, stem cell applications, cupping therapy, dry needling should be used. It has been stated that botulinum toxin injection lasts longer than steroids (cortisone) and has fewer side effects. Unconscious exertion can cause fractures of the humerus, shoulder dislocations, brachial plexus injury, and rupture of the rotator cuff muscles. While applying surgical methods, care should be taken here because the axillary nerve passes under the inferior capsule during capsulotomy. Excessive relaxation has possible negative consequences such as axillary nerve palsy and shoulder dislocation. It is essential to continue the exercise in order to ensure the continuity of the joint movements gained following the treatment.
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