As the "frozen shoulder" disease, which causes pain and restriction of movement in the shoulder joint, progresses, shoulder movements are restricted. Affecting women more than men and more common between the ages of 40 and 60, frozen shoulder reduces the quality of life. Stating that it can take up to 3 years to fully recover from the onset of symptoms, experts underline that the primary treatment approach is physiotherapy.
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Üsküdar University Faculty of Health Sciences, Head of Physiotherapy and Rehabilitation Department Prof. Dr. Defne Kaya drew attention to the fact that "frozen shoulder" disease reduces the quality of life.
Frozen shoulder affects women more
Stating that frozen shoulder disease affects women more than men, Prof. Dr. Defne Kaya said, "In frozen shoulder, which is more common between the ages of 40 and 60, the joint capsule thickens and hardens. Thick and tense bands form in the shoulder joint. The synovial fluid that facilitates the movement of the joint and nourishes the intra-articular structures is very reduced."
It develops more frequently in diabetics
Stating that the cause of the disease is not known exactly, Prof. Dr. Defne Kaya said that some risk factors have been identified today. Prof. Dr. Kaya listed these factors as follows:
"Diabetes: It is known that frozen shoulder develops more frequently in diabetics. The reason for this has not yet been solved. It is thought that it may be due to the metabolic effects of diabetes. In diabetics who develop frozen shoulder, shoulder movement is more restricted, the thawing phase takes longer, and shoulder movements remain restricted for a long time during the thawing phase.
Other diseases Frozen shoulder develops frequently in thyroid diseases, after heart diseases and surgeries, and in Parkinson's disease. The relationship between these diseases and frozen shoulder is not known.
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Plaster applications, situations where movement is restricted / prohibited after surgery: Frozen shoulder may also develop after fractures, injuries or surgery where movement is restricted or prohibited."
Frozen shoulder develops in three stages
Stating that frozen shoulder disease develops in three stages, Prof. Dr. Defne Kaya continued his words as follows:
"Stage 1 / Beginning to freeze, inflammatory stage: This is the stage where the pain gradually increases and becomes unbearable. When the pain is unbearable, shoulder movement gradually begins to be restricted. This stage can last from 6 weeks to 9 months, depending on the patient's comorbidities.
Stage 2 / Freezing: The pain gradually starts to decrease, but the restriction of movement continues. In fact, whatever movements were restricted in the first stage remain restricted in this stage. The shoulder is stiff. Daily activities become restricted and difficult. The duration of the second stage can continue for 4 to 6 months.
Stage 3 / Resolution: Shoulder movements gradually begin to resolve. It may take 6 months to 2 years to regain normal or near normal shoulder movement and shoulder muscle strength."
Pay attention to these symptoms
Prof. Dr. Defne Kaya stated that movements are restricted and stiff due to frozen shoulder and said, "In the early stages, the pain felt when the arm is lifted up is severe. In advanced stages, pain decreases and movement limitation increases. The pain is localized in the shoulder joint. Sometimes the pain can also hit the arm."
Not a preventable disease
Prof. Dr. Defne Kaya said, "Frozen shoulder is not a preventable disease as its cause is unknown." Prof. Dr. Defne Kaya said, "When diagnosed at an early stage, appropriate physiotherapy methods can be applied to enter the freezing phase with the least restriction. Even if no treatment is given, the limitation of movement in the shoulder will disappear within 2 or 3 years. But as you can appreciate, during this time the muscles weaken, the ligaments stiffen and the structures inside the joint lose their old properties. Therefore, spending this period without treatment, thinking that it will open anyway, will lead to irreversible loss of strength, flexibility and function in the shoulder. Frozen shoulder may recur after treatment. Although it is often seen in the dominant side shoulder, the other shoulder can also be affected."
Priority treatment Non-surgical methods
Stating that the primary treatment for frozen shoulder is non-surgical methods, Prof. Dr. Defne Kaya said the following:
"Anti-inflammatory drugs and intra-articular cortisone injections can be useful for pain control. Physiotherapy approaches also provide very good results. If the shoulder does not open within 6 months with all these methods, it is tried to open with a method called manipulation under anesthesia. After complete muscle relaxation is achieved during manipulation, your doctor loosens the capsule with various maneuvers and opens the shoulder movements. After the manipulation, the opening obtained should be maintained with physiotherapy and the muscles should be strengthened. If shoulder movements cannot be regained with manipulation, shoulder movements can be regained with one of the different surgical methods."
Physiotherapy is of great importance in treatment
Stating that physiotherapy is important in the treatment of frozen shoulder, Prof. Dr. Defne Kaya said:
"Regardless of the stage, physiotherapy is important in the treatment of frozen shoulder to restore the soft tissue and muscles around the shoulder joint. In frozen shoulder, not only the shoulder joint is affected, but also the movement of the shoulder blade, which plays an important role in shoulder movement, is restricted. Physiotherapy methods that respect the soft tissue and restore the shoulder to its former state and function without causing pain in the patient are applied in clinics that follow current treatment methods. The shoulder joint is the main point of our overhead movements. If shoulder movements such as combing hair, taking something from the shelf, waving, etc. are restricted, our life is restricted. Frozen shoulder treatment cannot be neglected, the underlying triggering disease must be examined and treatment must be added to the process."
