Frozen shoulder patients, that also suffer with diabetes, have it particularly tough. Surgical outcomes are also not as good for these people with the possibility of complications being much higher. Conventional treatments for adhesive capulistis frozen shoulder, such as physical therapy, cortisone injections, and hydrodilatation are usually less effective for those who have diabetes due to abberations of their connective tissue. The recovery time for a diabetic is also usually much longer for any medical procedure.
Frozen Shoulder and Diabetes
While there is a 3 to 5% incidence of frozen shoulder in the general population, frozen shoulder was thought to develop in 10% to 29% of people with diabetes although recent studies indicate that it can be as high as 36%! Not only that, diabetes detrimentally affects the connective tissues in the body which can complicate frozen shoulder treatment and recovery. These changes are the result of high glucose levels leading to glycosylation of the collagen within the shoulder joint causing the development of stronger and more stretchy scar tissue. This glycosylation leads to enhanced cross-linking among collagen molecules.
Dr. Oolo-Austin believes that, with diabetic patients, the changes in connective tissue combine with an exaggerated healing response to shoulder strains or injuries. The result, in the case of frozen shoulder and diabetes sufferers, is an uncontrolled and over-exaggerated inflammation response and an equally uncontrolled and exaggerated healing response. Thus, excessive amounts of strong, stretchy, scar tissue form over the capsule of the shoulder joint which can make it much harder for the scar tissue to be separated and dissected during the MCD procedure.
Anecdotally there are no studies to conclusively prove this but our diabetic frozen shoulder sufferers complain to us that their frozen shoulder adhesions are “sticky” and resistant to conventional treatments like physical therapy and Dr. Oolo-Austin has noted a more difficult time separating the shoulder adhesions. He has noted clinically that Type-1 diabetics do not improve as rapidly and take longer in their recovery. Ultimately, they may not improve as much as a non-diabetic patient due to the systemic nature of this condition. Hydrodilatation, where a saline and cortisone solution is injected directly into the shoulder capsule to try and break apart the adhesions from the inside out, has a higher failure rate with Type-1 diabetics. This is thought to be due to the more resilient adhesions failing to come apart in the intensely painful capsular hydrodilation procedure foir adhesive capsulitis.
Are Diabetics More Likely To Develop Frozen Shoulder?
YES. Currently 10% of the population suffer with diabetes with 90% of diabetics falling within the type 2 secondary form of diabetes that develops usually in their 4th decade of life. All diabetics (type 1 and type 2) have a greater predisposition to developing adhesive capsulitis frozen shoulder. Interestingly, however, the prevalence of diabetes with type 1 is 10.3% and with type 2 being 22.4% according to the latest research. All this being said, Dr. Oolo-Austin’s MCD Procedure to cure adhesive capsulitis frozen shoulder still usually works for diabetics with frozen shoulder. Joanna Grant, from Toronto, Canada, is a type 1 diabetic who had frozen shoulder. She was worried and scared about the stickiness of her adhesions—worried that the MCD Procedure wouldn’t be successful. But you can see the results in the video.
If you are diabetic and have frozen shoulder or if you just have frozen shoulder, please speak with one of our educational directors in a free phone consultation. We can even put you in touch with Joanna or other past diabetic patients who got their shoulders back after the MCD operation to fix frozen shoulder.
Video Transcript below
Dr. Austin Oolo (Dr. O): Good for you.
Assistant: Give her a round of applause!
Dr. O: Really, really good. Yeah.
Joanna: I competitively horseback ride. And I wasn’t riding I was actually just sitting and I just had a shoulder pain. And I thought that’s weird because I normally get injuries when I fall off a horse but it was just kind of an instantaneous pain and it just got worse over the weeks. It just got where I couldn’t move my arm over my head or it got where I could move my arm a little bit but not very much further. I didn’t know what it was so I went for an ultrasound and they said it was frozen shoulder which I’d never even heard of before. Then I googled it and they said it was basically because of all the scar tissue on the shoulder I couldn’t move it so. Did you try different therapies or anything? –I tried hydrodilation. Where I got I guess an injection of a saline solution and steroid. And they said that might break off the scar tissue. But it didn’t. It made the pain a bit less but I think that was due to the cortisone injection.
Dr. O: But it didn’t improve the motion.
Joanna: No, unfortunately…
Dr. O: Let’s see now. Your final go. Go ahead, lift them up.
Joanna: Oh, that’s better!
Dr. O: You see? Much easier.
Dr. O: Incredible, eh?
Joanna: Yeah, that’s much better. That’s… yay! Yeah. No stickiness!
Dr. O: And that’s it. It’s real easy that way.
Joanna: Yeah! The side one is the tough one.
Dr. O: Well congratulations!
Joanna: Thank you!
Dr. O: What do you have to say to all the people that are thinking about getting their life back and fixing their shoulders?
Joanna: I think they should do it and type 1 diabetics don’t be worried because I was scared because I’m type 1 and had worried about the stickiness. And it’s been fine!
Categorised in: Blog - World Frozen Shoulder Clinic