Shoulder stiffness is a condition where the motion of a group of ligaments (capsule) surrounding the shoulder joint is restricted. So the person is unable to lift his arm even with support. The arms show swelling and stiffness which induces severe pain in the shoulders. Women between the age 40 to 60 years are more commonly affected. People with diabetes or overactive thyroid disease are also prone to stiffed shoulders.
The various causes of shoulder stiffness are:
- Shoulder arthritis
Shoulder arthritis is another cause of stiff shoulder. Shoulder arthritis wears away normal smooth cartilage surface of shoulder joint. Thus a rough surface appears. This enhances the stiffness in shoulders.
- Bone spurs
Shoulder arthritis often causes bone spurs to appear in the shoulder. These spurs interfere with the normal functioning of the shoulder joint. As a result, shoulder experiences stiffness.
Severe pain, movement limitation and stiffness are the common symptoms of stiffed shoulder. The symptoms are basically divided into three phases:
- Phase one (Painful stage):
In the initial stage, the person experiences severe pain. Gradually, limited movement and stiffness builds up. At night, the pain usually increases. This condition lasts 2-9 months.
- Phase two (Frozen/stiff stage)
This stage typically lasts for 4-12 months. Although, there is a decrease in pain but stiffness and limited movement further worsens. All shoulder movements, especially outward rotation of arm, are seriously affected.
- Phase three (Thawing/recovery stage)
There is a gradual increase in pain and stiffness. However, the near or full normal movement of shoulder joint is achieved.
The treatment basically aims to correct the pain, stiffness and limited range of motion of shoulder. The treatment may be non-operative or an operative procedure.
- Non-operative Treatment
Various non-operative treatment options used are:
Painkillers are helpful in treating the symptoms of pain. Paracetamol and codeine are the commonly advised painkillers. Codeine may sometimes cause constipation problem. In addition to ordinary painkillers, some non-steroidal anti-inflammatory drugs(NSAIDs) may also be used. They tend to reduce both inflammation and pain of the shoulder. The intake of these painkillers should be strictly under the review of a doctor.
- Shoulder exercises:
The shoulder exercises aims to reverse the shoulder stiffness. They help to provide complete movement of the shoulder. However, these exercises should be done on regular basis.
Physiotherapy includes simple exercises to reduce the symptoms. They also consist of pain-reducing methods such as hot or cold compression packs, transcutaneous electrical nerve stimulation(TENS), etc. The alternate use of hot and cold packs is helpful to ease pain and swelling in the shoulders. TENS are used to numb the spinal cord nerves which control pain. Small electric pads placed on the skin of affected shoulder receives electric pulses from TENS machine. This decreases the effect of pain.
- Corticosteroid injections:
Steroid hormone or injections are often used to lower the swelling and pain discomfort. These injections are injected near or into the affected shoulder joint. However repeated use or overdose is discouraged as it may permanently damage the shoulder movements. They give only temporary relief and symptoms often recurs.
- Surgical Treatment
In case, other treatments do not help in relieving the symptoms, surgical treatment is chosen. Prior to surgery, the patient is kept under local or general anesthesia. Techniques included in surgical process are:
- Shoulder Manipulation:
In this procedure, the surgeon gently moves the shoulder joint.
- Shoulder Arthroscopy:
This type of surgery is minimally invasive and usually done as a key-hole surgery. A small cut is made in the shoulder joint. This cut is used to insert an endoscopic tube. Adhesions and scar tissue can be removed through this tube.
After the treatment is over it is better to go for a rehabilitation program. A rehabilitation program consist of effective and simple exercises to improve the range of motion. For every individual, the time for starting the rehabilitation program is different. With the help of such program, the person is able to return to work at the earliest. Physical therapy helps to recover fast and provide a healthy body. The rehabilitation program usually lasts for about 12-16 weeks.