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Frozen Shoulder (cont.)

When to Seek Medical Care

Anyone with limited motion of the shoulder joint should seek the medical attention of a health-care professional.

Exams and Tests

In evaluating a frozen shoulder, the doctor will consider the history of events that may have injured the shoulder joint. Any activity that could strain or injure the shoulder joint can lead to a frozen shoulder, including lifting a heavy object overhead, picking up luggage off of a luggage rack, or using shears to clip a hedge. A frozen shoulder is suggested during examination when the range of motion in the shoulder joint is significantly limited, with either the patient or the examiner attempting the movement. Underlying diseases involving the shoulder can be diagnosed by the medical history along with the physical examination, blood testing, and X-ray examination of the shoulder. If necessary, the diagnosis can be confirmed when an X-ray contrast dye is injected into the shoulder joint to demonstrate the characteristic shrunken shoulder capsule of a frozen shoulder. This X-ray test is called arthrography. The tissues of the shoulder can also be evaluated with an MRI scan.

Frozen Shoulder Treatment

The treatment of a frozen shoulder usually requires an aggressive combination of antiinflammatory medications, cortisone injection(s) into the shoulder, and physical therapy. Without aggressive treatment, a frozen shoulder can be permanent. Diligent physical therapy is often key and can include ultrasound, electric stimulation, range-of-motion exercise maneuvers, ice packs, and eventually strengthening exercises. Physical therapy can take weeks to months for recovery, depending on the severity of the scarring of the tissues around the shoulder. It is very important for people with a frozen shoulder to avoid reinjuring the shoulder tissues during the rehabilitation period. These individuals should avoid sudden, jerking motions of or heavy lifting with the affected shoulder. Frozen shoulders can be resistant to treatment. Other treatments such as release of the scar tissue by arthroscopic surgery or manipulation of the scarred shoulder under anesthesia may be considered for patients with resistant frozen shoulders. The manipulation is performed to physically break up the scar tissue of the joint capsule. This procedure carries the risk of breaking the arm bone (humerus fracture). It is very important for patients that undergo manipulation to partake in an active exercise program for the shoulder after the procedure. It is only with continued exercise of the shoulder that mobility and function is optimized.

Over-the-counter pain relievers, such as ibuprofen (Motrin, Advil), can be used to treat pain. Cold packs can be applied to the shoulder after exercise to minimize inflammation and pain after exercise.

Medically Reviewed by a Doctor on 9/8/2014

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