If you’ve ever had an injection like a pain killer or vaccination; you’ll have some idea of what frozen shoulder feels like. After an injection, your bicep and adjoining area may be really tight and painful. These are mild versions of what would usually be severe symptoms for sufferers of frozen shoulder a.k.a. adhesive capsulitis. Frozen shoulder itself occurs when the shoulder joint becomes inflamed and contracts. Heavy layers of scar-like fibrous tissue is laid down joining the 2 sides of the joint capsule together literally freezing it immobile
The True Cause of Frozen Shoulder
There are numerous potential causes and situations which can initiate and/or contribute to the development of frozen shoulder. These include situations where the arm is immobile like diabetes, psychosomatic overlay due to stress, and injuries requiring the use of an arm sling. The presence of a hormonal imbalance strongly correlates with frozen shoulder. Injury to the shoulder muscle/tendons and unnoticed pain which causes weakness and stress to the shoulder can also be a cause.
According to Dr. Oolo-Austin, the true cause of frozen shoulder is the immune system’s overreaction to what could even be a mere pull or scar in the adjoining tissue. When even a small amount of damage occurs at a time when the aforementioned conditions exist, the hormonally induced dysfunctional auto-immune system begins the normal healing process with inflammation and the laying down of scar tissue where necessary. Unfortunately, in those predisposed to the development of frozen shoulder, the auto-immune system not only over-reacts with excessive inflammation causing severe joint pressure and intense pain, but it does not know when to shut off the process of responsive scar tissue formation. This causes over-proliferation of fibrous scar tissue around the joint capsule. The capsule and joint become adhesed (locked in place) and excessively swollen. In medical terminology the suffix “itis” means swelling. So tendonitis means swelling of the tendon. Adhesive capsulitis refers to the presence of adhesions along with swelling in and around the shoulder capsule.
Identifying what triggered frozen shoulder can be difficult. A trigger could be something as simple as improper exercise or strain from lifting something. A frozen shoulder sufferer often has no such memory of an associated or determinable injury. This is because a minor injury like a small tear to the shoulder tendon can be seemingly inconsequential and the brain would fail to register it at the time. Then what happens is that the reactive healing inflammatory response, referred to as the inflammation cascade, begins to take place slowly after the injury with the peak of inflammation in the tendons and joint occurring three days after the actual time of injury. It literally gets worse for three days, then it begins to get better. And three days later, the fact that you had lifted that suitcase and felt a slight twinge is totally forgotten. Many frozen shoulder sufferers, therefore, don’t remember what they did and/or cannot correlate anything that may have triggered their frozen shoulder to develop. The true cause of frozen shoulder, then becomes a mystery. Add to this that the inflammatory over-reaction phase in cases of adhesive capsulitis frozen shoulder, will continue for much longer than three days with most cases lasting at least three months!
Diagnosis of Adhesive Capsulitis Frozen Shoulder
The description of adhesive capsulitis as a frozen shoulder refers to shoulder joint (glenohumeral) immobility so testing to see if the shoulder diagnosis is, in fact, adhesive capsulitis is actually quite simple. Lifting your arm up straight in line with your side, past 20-90 degrees is impossible and causes severe pain. This is the main test. In addition, if you cannot rotate your arm outwards with the elbow held in to your body or turn it inwards with the elbow held away and up from your body, you most likely have the adhesive capsulitis type of frozen shoulder. It is likely that you will also be unable to do simple things like putting your hand on your hip, reaching up behind your back, or putting your hand easily up over the top of your head. Certain other conditions are frequently mistaken for the adhesive capsulitis variety of frozen shoulder with the main one being frozen shoulder impingement syndrome. With frozen shoulder impingement syndrome, you will often not be able to raise your arm up to your side more than 90-120 degrees but putting your arm behind your back or turning it outward when the elbow is held by your side is usually possible.
Categorised in: Blog - World Frozen Shoulder Clinic