Frozen Shoulder.

Frozen shoulder, also known as adhesive capsulitis is a disorder that cause stiffness thereby resulting in pain in the shoulder joint. This condition leads to the loss of normal range of motion of the shoulder, leaving the affected individual unable to perform even simple physical activities like reaching for objects placed on an overhead shelf. A frozen shoulder can get significantly worse if left untreated. In most cases, the problem deteriorates, and then goes away over the course of time, usually over a period of 1 to 2.5 years.

Symptoms

Dull, lingering pain in one of the shoulders or in the muscles of the outer shoulder and upper arm region accompanied by stiffness of the shoulder joint are common symptoms of frozen shoulder. The pain may worsen at night in some cases. Most patients will experience pain at the slightest movement of the shoulder.

Who all are at risk?

For reasons yet unclear, women are more likely to develop a frozen shoulder than men. People belonging to the age group of 40-60 years old and those recovering from a stroke, mastectomy and other medical conditions that restrict the movement of arms are most likely to be affected by a frozen shoulder. 

Individuals suffering from heart and thyroid related issues (hyperthyroidism/ hypothyroidism), tuberculosis, cardiovascular disorders, Parkinson’s disease and diabetes too have a high susceptibility to developing a frozen shoulder.

In addition, individuals recovering from tendinitis or injuries that cause them to wear a sling for several days are also at the risk of getting a frozen shoulder in absence of regular stretching. An estimated 10 percent of people suffering from rotator cuff disorders are affected by frozen shoulder.

Diagnosis

A physical examination is required for diagnosing a frozen shoulder. This involves active and passive movement tests. In the ‘active’ part, the doctor will have the affected individual move the shoulder on his/her own to get a measure of pain and stiffness. In the ‘passive’ leg of the examination, the doctor will move the affected individual’s shoulder to gauge the differences in discomfort and range of motion. 

In some instances, the doctor can administer anesthesia to numb the shoulder in order to carry out the physical examination. In addition, imaging tests such as X-ray, MRI or ultrasound may also be required if the doctor suspects a torn rotator cuff, arthritis or a similar condition to be the underlying cause of shoulder distress.

Treatment

In some cases, non-steroidal anti-inflammatory drugs are prescribed to alleviate the pain, especially if there’s noticeable swelling in the affected shoulder. If there is significant inflammation or pain, the doctor can prescribe different, more potent medications.

Physiotherapy has been found to be effective in improving mobility of the shoulder and is often recommended. In severe cases wherein oral medication fails to bring relief, the doctor can revert to administering a corticosteroid injection into the shoulder joint.

Some rare cases may call for a shoulder surgery. The surgery is an arthroscopic or keyhole procedure.

Bursitis

Tender, swollen joints that ache when you move – you could be suffering from Bursitis, a painful medical condition wherein bursae – the small, fluid filled sacs that work as cushion between the bones, muscle and tendons around the joints have become inflamed. 

The human body has 150 plus bursae. Their primary function is providing lubrication to reduce friction between the tissue during physical activity. Joints like hips, shoulders and elbows that engage in frequent physical activity are the most commonly affected by Bursitis. 

Bursitis too can affect other joints, like the knee and the base of the big toe. Bursitis of the knee is commonly called “Housemaid’s knee” or “Clergyman’s knee”.

Symptoms

Bursitis is marked by easy to spot visual and physiological cues. These include – 

  • Stiffness and ache in the joint region.
  • Swelling and redness in the affected joint.
  • Experiencing increased pain when moving or putting pressure on the affected areas.

Causes

Bursitis is usually caused by repetitive movements that wear out or stress the bursae. Athletes and laborers whose daily routine involves lifting objects over their heads or kneeling for long durations are at a high risk of developing bursitis.

Something as seemingly innocuous as leaning on your elbows for long when studying or reading can also lead to bursitis. Ageing, rheumatoid arthritis, gout, infections and injuries suffered to the joint region are other common causes.

Diagnosis

Diagnosis of Bursitis involves an examination of the affected joint and inquiry into recent physical activities and injuries. In some cases, swelling and soreness in the joint can be accompanied by fever. In such an event, the doctor will draw a small quantity of fluid from the bursa close to the affected joint which will be tested.

You might have to undergo an X-ray if the doctor suspects a break or a fracture or MRI in case of torn tendons. If the doctor suspects rheumatoid arthritis, you might have to undergo some blood testing. 

Management

Minor discomfort and inflammation can be managed and cured by ice packs and rest. Raising the affected joint to reduce the blood flowing into it can also sometimes help to reduce swelling. 

If you experience a sharp pain in the joint, are unable to move, develop a rash and/or a fever, consult your doctor. Based on the underlying cause and diagnosis, the doctor may administer steroid injections at the site of the pain and/or prescribe a course of antibiotics. Some cases may require intravenous administration of antibiotics and surgical draining to reduce fluid buildup. 

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