Have you ever felt shoulder pain that gradually becomes more difficult to move, even for simple activities like combing your hair or getting dressed? This condition may not be just a simple ache, but rather frozen shoulder, or what's medically called adhesive capsulitis.
Frozen shoulder is a fairly common musculoskeletal disorder, particularly in middle-aged and older adults. This condition causes stiffness, pain, and limited movement in the shoulder joint, significantly impacting quality of life. Therefore, understanding frozen shoulder, its risk factors, symptoms, and prevention methods is crucial.
What Is Frozen Shoulder?
Frozen shoulder is a medical condition in which the shoulder joint capsule tissue becomes inflamed, thickened, and shrinks (fibrosis). This results in a narrowing of the joint's range of motion, causing pain and limiting shoulder mobility.
The shoulder joint itself is one of the most flexible joints in the human body. With its ball-and-socket structure, the shoulder allows for a wide range of movements, such as lifting, rotating, and swinging the arm. However, in frozen shoulder, the capsule surrounding the joint tightens, limiting these movements.
This condition usually occurs gradually over a long period of time, and can even last up to 1 to 3 years if not treated properly.
Stages of Frozen Shoulder
Frozen shoulder generally progresses through three distinct stages:
1. “Freezing” Stage (Initial Freezing)
- Pain in the shoulder started to appear.
- The pain gets worse when moving.
- Range of motion begins to become limited.
- This stage usually lasts 6 weeks to 9 months.
2. “Frozen” Stage
- The pain tends to lessen, but the shoulder becomes stiffer.
- Daily activities are increasingly disrupted due to limited movement.
- Lasts about 4 to 12 months
3. “Thawing” stage (melting)
- The stiffness slowly improved.
- Shoulder range of motion begins to return to normal.
- This stage can take 6 months to 2 years
Causes of Frozen Shoulder
The exact cause of frozen shoulder is still not fully understood. However, several conditions are often associated with this condition, including:
- Shoulder Immobilization: The shoulder is rarely moved for a long period of time, for example after surgery, injury, or fracture.
- Inflammation: There is inflammation in the tissue around the shoulder joint.
- Connective Tissue Disorders: Thickening and shrinkage of the joint capsule.
- Concomitant Diseases: Several chronic diseases such as diabetes, heart disease, stroke, hypothyroidism, and Parkinson's are known to increase the risk of developing frozen shoulder.
Frozen Shoulder Risk Factors
Some factors that can increase the likelihood of someone experiencing frozen shoulder are:
1. Age
- Most often occurs at the age of 40–60 years.
2. Gender
- Women experience frozen shoulder more often than men.
3. Chronic Disease
- People with diabetes have a risk that is up to 5 times higher.
- Hyperthyroidism, hypothyroidism, tuberculosis, and cardiovascular disease are also closely related.
4. Lack of movement
- Shoulders that are rarely moved, for example after surgery or injury, are very susceptible to stiffness.
Frozen Shoulder Symptoms
The main symptoms of frozen shoulder can be recognized through the following signs:
- Dull or stabbing pain in the shoulder, especially when moving.
- Stiffness that makes it difficult to lift or rotate the arm.
- The range of motion of the shoulder is limited, both when moving it yourself and with the help of another person.
- Difficulty performing simple activities such as buttoning clothes, raising arms overhead, or reaching for objects behind the back.
Frozen Shoulder Prevention
While not all cases of frozen shoulder can be prevented, there are steps you can take to reduce your risk:
1. Keep actively moving your shoulders
- Avoid leaving your shoulder still for too long after injury or surgery.
- Do light range of motion exercises every day.
2. Post-Injury/Surgery Physiotherapy
- Follow the doctor's or physiotherapist's advice to prevent stiff shoulders.
3. Healthy Lifestyle
- Control chronic diseases such as diabetes or thyroid disorders.
- Maintain ideal body weight and exercise regularly.
4. Shoulder Stretching Exercises
- Pendulum stretch: Lean forward, let your arms hang down, then swing them slowly in small circles.
- Cross-body stretch: Pull your arms towards your chest and hold for a few seconds.
- Towel stretch: Hold the towel behind your back with both hands, then pull slowly.
5. Pay attention to your body posture.
- Avoid the habit of bending or being in a static position for too long.
Frozen shoulder is a medical condition that causes pain, stiffness, and limited movement in the shoulder joint due to thickening of the joint capsule. This condition develops gradually through three phases: freezing, freezing, and thawing, and can last for years.
The exact cause isn't entirely clear, but risk factors such as age, gender, chronic illness, and lack of shoulder mobility play a role. Diagnosis is made through a physical examination and medical imaging, while treatment includes medication, physiotherapy, injections, and, if necessary, surgery.
The best prevention is to maintain shoulder mobility by staying active, stretching regularly, managing chronic illnesses, and maintaining good posture. These steps can minimize the risk of frozen shoulder, ensuring it remains healthy and doesn't interfere with daily activities.
Article written by Dr. Dipa Yunta Firmanda, Sp.OT (Orthopedic & Traumatology Specialist Doctor, Cikarang).