What is Frozen Shoulder? Is it common among women with diabetes?
The official medical term for frozen shoulder is adhesive capsulitis. The shoulder joint becomes stiff and scarred which causes restriction of motion in the shoulder and pain. Brushing your hair and raising your arms to take off your shirt can be painful and even difficult to do. The shoulder joint is a ball and socket joint where the ball is the top of the arm bone and the socket is part of the shoulder blade. A capsule of tissue surrounds this ball and socket joint. The shoulder joint normally has more range of motion than any other in the body, but in frozen shoulder, the capsule that surrounds the joint contracts and bands of scar tissue form called "adhesions". These two things cause the shoulder to become stiff and painful. Typical symptoms of frozen shoulder include shoulder pain-dull, aching pain, limited range of motion, pain if one tries to sleep on the affected shoulder.
Frozen shoulder has 3 stages:
1) the freezing stage which is the most painful stage can last 6-12 weeks.
2) the frozen stage which is less painful but the shoulder has more stiffness and can last 4-6 months.
3) the thawing stage which is gradual and can last more than a year and range of motion steadily improves.
The next question may be why does this happen? The cause is uncertain and there is not necessarily any shoulder injury associated with it. There are risk factors, however, and these include age and gender, endocrine disorders, shoulder injury and systemic conditions such as heart disease and Parkinson’s . Typically frozen shoulder is seen in individuals between the ages of 40- 60 and women are twice as likely to develop it as men. Frozen shoulder has been reported in 19-29% of people with diabetes compared to 5% in people without diabetes. Why? We don’t really know unfortunately. If you think that you may have frozen shoulder, see your healthcare provider for an official diagnosis and referrals for treatment.
Typically individuals with frozen shoulder are referred to physical therapists for exercise and stretching programs that can help to increase range of motion as well as limit the loss of muscle in the affected shoulder. The physical therapist can also offer other treatment modalities such as ultrasound, ice and heat. Other treatment options include anti-inflammatory medications and cortisone injections. If a healthcare provider recommends a cortisone injection, make sure they know that you have diabetes and if you plan to have the cortisone injection, call your diabetes provider as cortisone can greatly raise your blood sugar. Your physician may have recommendations about your medications if you plan to have the cortisone injection. If these treatments do not work, people may need to have surgery. Surgery for frozen shoulder involves a manipulation of the shoulder made under anesthesia, where the surgeon moves the arm to break of the adhesions. Also, the surgery may include an arthroscopic capsular release, where an arthroscope is inserted to cut through the adhesions. This can be extremely useful in cases where the person did not respond well to rehab and therapy. If surgery is deemed necessary, physical therapy must begin immediately afterward to ensure a good recovery.
For me personally, I am in that 40-60 age group, am female, have had diabetes 40 years and have suffered from shoulder trauma! UGH ! I am doing the recommended exercises and really trying hard to do them everyday to hopefully avoid surgery. However if that does become necessary, I know other people who have lived through and have done quite well so I know I can too!