Frozen Shoulder - Frozen Shoulder

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Frozen shoulder (frozen shoulder)

If the shoulder is frozen, the shoulder joint gradually “freezes”, hence the name “frozen shoulder”. At first it is the pain, later the restriction of movement that is very uncomfortable for those affected. However, a stiff shoulder almost always heals well, but a lot of patience is required…

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• Frozen shoulder: what is it?
• Phases of the frozen shoulder
• The diagnosis
• Therapy options
• Whom can I ask?
• How are the costs going to be covered?

Frozen shoulder: what is it?

Frozen shoulder is a disease of the shoulder that causes pain and, as a result, restricted movement of the shoulder. There are indications that, for reasons as yet unknown, inflammation occurs and, as a result, swelling of the joint capsule and the associated ligaments. The resulting changes in the capsule ultimately lead to restricted mobility.

Note In medical jargon, frozen shoulder or "frozen shoulder" is called adhesive capsulitis (also: capsulitis adhaesiva).

The frozen shoulder usually develops gradually and usually for no apparent reason. A frozen shoulder rarely occurs after the shoulder has been immobilized or after an accident. There is also a connection with the occurrence of other diseases such as diabetes or thyroid diseases.

In the beginning the pain is predominant, then the shoulder joint becomes stiff. At the beginning of the disease only the active movement of the shoulder is restricted, later also the passive movement. It rarely affects younger people. The age of onset often lies between the ages of 50 and 60. Slightly more women than men are affected by frozen shoulder.

Phases of the frozen shoulder

Characteristic of a frozen shoulder is its course in the phases "pain" - "stiffening" and "loosening the stiffening". These phases are of different lengths and the respective duration can vary from person to person.

pain

At the beginning of a frozen shoulder, pain is predominant. Especially at night, these are very uncomfortable when you lie on your shoulder. The pain comes from an inflammatory reaction in the shoulder. In this phase, mobility in the shoulder joint is not too restricted. The acute painful phase with inflammation can last up to two months.

stiffening

In the next phase of the frozen shoulder disease, the pain subsides and the shoulder joint begins to stiffen. Little by little the mobility of the shoulder becomes less and less until it is mechanically blocked. As a result of the restriction of movement, the shoulder muscles begin to break down. The stiffened shoulder stage lasts two to six months. The shoulder stiffness can then persist for up to a year.

Loosen the stiffener

After a long period of stiffening, the shoulder begins to loosen, it "thaws", so to speak. How long the stiffening lasts varies greatly from person to person. Patients must be very patient at this stage of the disease, as this process can take up to two years.

The diagnosis

The doctor will obtain detailed information from the patient (anamnesis) about the pain and restricted movement of the shoulder. As a rule, he / she will inquire how long the pain has existed, where exactly it can be felt, with which movements it occurs, what type of pain it corresponds to and whether previous treatments have already been carried out. It is also interesting to know whether the pain is particularly severe at night. He / she will also ask what job or what hobbies (sports etc.) you have, what pre-existing illnesses you have, what illnesses you have in the family and what medication you are taking. During the physical examination, the doctor will pay particular attention to the position and interaction in the shoulder.

Usually the diagnosis is clear from the doctor's examination. If the shoulder is frozen, imaging techniques are rarely used. An x-ray of the shoulder may be required to identify possible signs of wear and tear. An MR examination is very rarely required.

Therapy options

If a frozen shoulder has been diagnosed, the focus is usually on relieving the pain at the start of treatment. On the one hand, painkillers with anti-inflammatory effects such as NSAIDs (oral) and glucocorticoids such as cortisone (oral or as an injection into the shoulder) are used. Cold applications such as cool packs can also lead to an improvement in pain.

Injecting a solution of water, table salt and cortisone (distension) can help stretch the shoulder joint and relieve pain.

Physiotherapy, which can support the healing process, is usually carried out from the start. Stretching exercises and strengthening training are carried out together with the physiotherapist. Usually no surgery is necessary if the shoulder is frozen.

Frozen shoulder therapy requires a lot of patience, as it can take a long time for the pain to subside and for full shoulder mobility to be restored.

Additional methods include laser, magnetic field or short wave therapy. Overall, the effect of these methods has not been scientifically well researched or proven.

Whom can I ask?

Do you have shoulder problems? To clarify pain in the shoulder, it is best to contact the following offices:

• General Practitioner,
• Specialist in orthopedics,
• Specialist in physical medicine and general rehabilitation,
• Specialist in trauma surgery,
• possibly pediatrician (frozen shoulder is rare in children).

How are the costs going to be covered?

The costs of the diagnosis and treatment of a frozen shoulder are usually covered by the social security authorities.

Physiotherapy (physiotherapy or remedial gymnastics)

If physiotherapy is prescribed by a doctor and the physiotherapist has a contract with your health insurance provider, the costs will be settled directly with the health insurance provider. In certain cases or from a certain number of treatments, a chief physician's approval is required.

In the case of an elective therapist (they have no contract with a health insurance provider), the health insurance provider pays 80 percent of the respective contractual tariff if a doctor's prescription and, if necessary, a chief doctor's approval are available. Certain social security agencies offer physiotherapy in their own facilities. The therapy is determined by the medical management; no prior authorization is required in this case. For more information, please contact your social security agency.

Further information on the cost coverage of physiotherapy, for example during a stay at a spa or in hospital, is available from Physiotherapist.