Thawing the 'frozen shoulder' mystery 11

Thawing the 'frozen shoulder' mysteryIs your shoulder freezing,

frozen, or thawing? If have suf-fered from a "frozen shoulder,"you are all too familiar withthese terms.

Frozen shoulder syndrome(adhesive capsulitis) is a poorlyunderstood and painful condi-tion. People between the agesof 40 and 60 are most likely todevelop a frozen shoulder, butno one seems to know why. Itmay occur after an injury orsurgery, but often it appears tostart for no reason at all.

For years, frozen shouldersyndrome has been thought ofas a "self-limiting condition"by the medical community,meaning it will go away in time.However, new treatments andresearch are attempting to thawthe frozen shoulder mystery.

Frozen shoulder typically fol-lows a pattern. In the earlystages, flexibility and pain get

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worse. Movement becomes veryrestricted during the day andpain affects sleep at night. Forthese reasons, the first stagehas been labeled the "freezing"stage. About one third throughthe process of a typical courseof frozen shoulder syndrome,the flexibility loss and pain hita plateau ("frozen stage").

Finally, both the pain andflexibility start to improve("thawing stage"). Eventually,most "frozen shoulders" returnback to normal, but it takes anaverage of 30 months.

Research has shown that

TIPS TO RELIEVE PAIN• Let the arm dangle and swing it gently from side to side.• Rest the arm on an armrest or place it in a sling

occasionally during the day for relief.• Stop all aggressive stretching and strengthening.• Sit or stand up straight when you move your arm; it

creates more space in the shoulder joint and will reduce pain.

aggressive rehabilitation doesnot shorten the length of frozenshoulder syndrome. More inva-sive treatments such as steroidshots and manipulation (aggres-sive stretching under anes-thesia) show mixed results.

However, newer training andrehabilitation techniques areproving fruitful. Patients arefeeling pain relief in one to twotreatments and regaining up to30 degrees of movement theirfirst visit. This can mean thedifference between barely

reaching the steering wheel anddriving without pain again.

Another piece of advancedtechnology, low-level lighttherapy (laser therapy), is alsoshowing promise. Laser therapyemits light into the inflamedtissue and actually acceleratesthe natural healing process.Adding laser therapy to analready effective therapy pro-gram may result in a fasterrecovery.

Joan Ward is a physical therapistin Rochester and works at ActivePT.