How to treat capsulitis of the shoulder joint (frozen shoulder)
Adhesive capsulitis shoulder — a reason to address urgently to the doctor!
The shoulder joint is considered one of the most important in the human skeleton. It is formed by three bones — the humerus, clavicle and scapula, a portion of each of which is coated with the liquid inside.
This shell, which protects the bones from friction between them called the joint capsule.
Damage to the capsule, which is manifested by severe pain and reduced mobility in the shoulder area, called adhesive capsulitis shoulder. It is sometimes announced as «frozen shoulder».
Causes and risk factors
Accurate determination of the causes of the disease currently does not exist. But doctors have identified some factors influencing its development:
- getting mechanical injuries (fractures, contusions) in the shoulder region;
- the presence of old injuries near the joint of the shoulder;
- the development of heart attack, stroke, heart surgery;
- inflammation of the joint and cartilage of the shoulder;
- diabetes mellitus requiring permanent insulin, which disrupts the metabolism in the body;
- the presence of cervical, thoracic degenerative disc disease in medical history;
- the hormonal background, for example, during female menopause;
- a job that involves spending long periods in a pose with hands raised.
The reason capsulitis are often comorbidities. Inflammation in the shoulder can begin on the background of diseases of the respiratory, nervous or cardiovascular systems, diseases of the joints.
Stage of development
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This disease is characterized by development in 3 stages, the duration of each of which is about 4 months:
- The first stage. This phase of the disease can last for a long time — up to 9 months. The person feels pain in the shoulder, especially during intensive work or exercise. The shoulder gradually loses its usual movement, the person experiences slight pain and discomfort.
- The second stage. This is the period of the height of the disease when the limitation of motion of the joint of the shoulder becomes serious. The patient is difficult to raise an arm, not feeling pain is fairly high. The duration of this period will depend on how effective will be prescribed treatment.
- The third stage. The last phase capsulitis the shoulder joint is characterized by its gradual decay and increase of joint mobility of the shoulder. If the treatment in the previous stage was adequate, and the patient has completed all medical treatments, the health of the shoulder can be returned quickly.
Practice shows that shoulder capsulitis can last from one year to three years. And in some cases to get rid of the discomfort in the shoulder is not completely possible throughout life, although this is rare.
The dependence of the symptoms of the stage of the disease
Syndrome frozen shoulder is diagnosed most often in people over the age of 40 and suffer from it, mostly women.
Doctors say that is affected by the disease usually redominantly hand, and the Association of development capsulitis with a history of injuries of the shoulder can not be traced.
No pathology in the joint of the patient on x-ray usually is not detected.
In the first stage symptom of the disease are pain in shoulder joint in movement and rest and decrease his mobility.
At night, the pain becomes more intense, progressing for some time. The patient tries to limit movement of the limb, to find a comfortable position for her.
The second stage of the disease, which is characterized by such symptoms as increased pain, greater reduction of mobility in his shoulder than the original, completed only after intensive treatment.
For the third phase capsulitis shoulder joint characteristic symptoms of remission of the disease, when the pain gradually goes away, the shoulder becomes more agile, which leads to recovery.
The address of the patient to the doctor usually occurs in the period when the disease progresses. The clinical picture is made on the basis of complaints of the patient. Then assigned x-ray examination and ultrasound.
But the most effective is the method of arthrography, allowing you to see the actual reduction in the volume of the capsule in the joint. This is considered normal value at 12 ml. If there is joint pathology, the volume of liquid in the capsule is fixed at the level of 2-3 ml.
For diagnosis seems to a blood test. If the analyzed indicators will be in the normal range, capsulitis will be excluded from the list of diseases of the patient.
In some cases, to conduct diagnosis based on the results of an MRI (magnetic resonance therapy) or CT (computed tomography).
Treat and do not mutilate
The goal of treatment is capsulate the relief of the patient, ridding it of pain and to restore mobility of the shoulder in full.
Selected methods of treatment for adhesive capsulitis shoulder depending on the stage of the disease.
In phase 1 the doctors-rheumatologists prescribe conservative methods that allow you to quickly get rid of the pain and still achieve the mobility of the shoulder joint. In most cases conservative treatment of the disease is sufficient.
These methods include:
- medication and non-steroidal anti-inflammatory drugs;
- therapeutic blockade of the suprascapular nerve for the treatment of severe pain;
- the exercise (only on prescription).
Turning to the doctor in the first months of the disease, these methods may help the patient. But all of these activities will be inefficient, if the tissue of the capsule appeared of pathological adhesions, fibroids or scars.
In this case, to restore the functionality of the shoulder is possible only through surgical intervention.
Is arthroscopic surgery to get rid of scar and inflamed tissue in the shoulder and return of full limb mobility.
The operation consists in the introduction into the joint cavity of the arthroscope with a camera through an incision in the skin to search for the affected area of the shoulder.
A special instrument placed through another puncture to correct abnormalities of the joint capsule exposed to cold plasma. After the operation the patient returns freedom in the movements of the limb.
Development of joint
As you recover, you need to develop a shoulder joint in order to achieve his former mobility.
Daily with frozen shoulder, you should perform some exercises on the advice of a doctor, which consist in raising and lowering arms, their rotational movements.
A good result, as practice shows, gives the exercise for which the hand is moved back, obkladyvaetsya the other hand, and then reaches to the buttocks.
These sessions should not be painful. And strain on the joint should be increased gradually so as not to damage the shoulder again.
Complications of the disease
Rare the surgery is performed without complications. Factors that increase the risk of their occurrence, are:
- chronic diseases, especially migrated in recent times;
- bad habits (alcohol, Smoking);
- taking drugs that increase the risk of bleeding;
- shoulder surgery performed earlier.
For possible complications, which warn doctors, are bleeding, infection, damage of soft tissues or nerve endings, negative reaction to anesthesia, fixed joints, fracture.
Urgently address to the doctor is necessary in the following cases:
- the pain does not subside even after taking painkillers;
- appeared fever or chills, indicating that the presence of infection;
- there are feelings of numbness, tingling in the limbs;
- appeared swelling, bleeding, discharge from the puncture;
- there is vomiting, nausea.
After arthroscopy, the pain may persist for several weeks, while complete recovery occurs after 3-6 months.
For recovery to work shoulder went without complications must adhere to the following points:
- during the first two days after surgery, keep the ice for 20÷30 minutes in a swollen area;
- to take painkillers;
- constantly change the dressing;
- the first time after surgery to sleep in my chair, tucked under his elbow the pillow;
- exercise recommended by your doctor.
Adhesive capsulitis is considered to be a widespread phenomenon, which lowers the quality of life by limiting his movements, but if you adhere to all recommendations of the attending physician, to get rid of this disease can quickly and without complications in the first phase of its development.