Understanding Shoulder Pains and Problems


Ever wonder why shoulder problems are so common? Think of the shoulder is a modified ball and socket joint, a good design for mobility, but an unstable one nevertheless, making dislocation and injury to the area fairly common. To improve the stability of the shoulder, a cuff of four muscles, referred to as the rotator cuff, stabilizes the joint. Surrounding the shoulder joint is a "bag" called the Capsule.

Frozen shoulder syndrome starts in this sack-like area that stretches when the arm is raised above the head and hangs down like a sack when the arm is lowered to the side. In frozen shoulder syndrome, inflammation of the joint causes this sack to stick to itself. The inflammation spreads and can cause swelling throughout the shoulder area. Within several days, arm movements start to diminish. Within a few weeks, the arm literally becomes frozen and in many cases can not be raised more than 40 degrees. As a result, the muscles of the rotator cuff become weak and start slowly to waste away. Muscle atrophy sets in, rendering the entire arm totally useless.

A painful and often debilitating condition, Frozen shoulder syndrome affects 2-5% of the population. It is more common in women and diabetics are particularly vulnerable to the affliction. It is mainly a problem that affects people 40 years and older. The arm that is used less is most likely the one to be involved; however, about 12% of people experience the problem on both sides. The condition lasts an average of 30 months and can be classified into three phases:

· Freezing

(1-8 months) – Considered to be the most painful phase of the condition, especially at night.

· Frozen

(9-16 months) – The arm becomes stiff. Pain may still be a problem especially at night, but it usually diminishes.

· Thawing

(12-40 months) – Characterized by recovery and the gradual return of mobility.

Most medical experts agree that conservative management, usually involving anywhere from 4-30 sessions of physiotherapy and exercise is the best way to treat Frozen Shoulder, however opinions and treatment methods vary among caregivers. Some administer cortisone injections, which typically relieve symptoms for only a week or two. Manipulation under general anesthetic followed by physiotherapy is also a possibility, however manipulation can cause further complications such as rotator cuff tears, increased inflammation and nerve damage. It might be helpful to seek the advice of several medical professionals before deciding on a treatment program that best suits your needs.