Posts Tagged ‘Period Of Time’

“the Impact of a Frozen Shoulder”

Help for shoulder pain

The syndrome known as Frozen Shoulder is characterised by painful loss of movement of the shoulder joint. In this case, the word “frozen” is analogous to “stiff”. “Adhesive Capsulitis” is a medical term for this syndrome.

The capsule surrounding the shoulder joint becomes thickened and contracted. A decrease in the amount of synovial fluid inside the capsule (fluid that supplies nutrition and lubricates the joint) decreases. The result is restriction of movement of the shoulder accompanied by pain. This restriction affects only certain movements of the shoulder, thus presenting a specific pattern.

Why the syndrome occurs is a bit of a mystery. It is more common in people between the ages of forty and sixty years and is often associated with a tendonitis or bursitis. It can occur in athletes following trauma if the shoulder is immobilized for an excessive period of time, but this seldom happens. Many people acquire the syndrome without any specific injury at all. It may develop in people following a virus and can even affect both shoulders of an individual consecutively over a period of years.

Pain, stiffness and recovery are the three phases of the frozen shoulder syndrome, which together can last for up to two years. In some cases it is possible that early intervention in the syndrome can help prevent the progression to a fully developed frozen shoulder and its lengthy involvement.

Maintaining a good range of motion is important but this must be done respecting pain limitations. Please be advised that ignoring the problem and compensating with the other arm is likely to contribute to further progression of this syndrome.

Warning signs to watch for are a progressive restriction of shoulder movement accompanied by varying degrees of pain. Other significant findings include waking up at night, being unable to lie on the given shoulder and pain radiating to the elbow or hand.

Seeing your GP early on is important so that other pathologies can be ruled out, and may help prevent the syndrome from becoming prolonged.

Medication can be indicated in some cases.

However Physical therapy can play a very important role in educating an individual on exercises appropriate for each stage of this syndrome in order to optimize healing time and pain management. This is usually done in “bouts” with long term monitoring of the condition. Frozen shoulders, as mysteriously as they come on, can self-resolve almost spontaneously after two years has elapsed.

However, proper management and education can certainly optimize a sufferer’s function and productivity during the prolonged course of the syndrome.

Terry O’Brien

Back Trouble UK

www.backtrouble.co.uk

Use ice to decrease pain

How to Treat Rotator Cuff Pain

Help for shoulder pain

Shoulder pain can develop from a microtrauma (a rather benign, repetitive activity) performed over a long period of time that gradually wears down the tendons in the shoulder until they become inflamed. It can also be caused by a macrotrauma (a more significant event or activity that can easily be identified as the source of the shoulder pain). This could be a fall onto the shoulder or onto the outstretched arm. Regardless of the cause of the pain the treatment is often similar from case to case with some individual variations.

Treatment of the shoulder can encompass several different areas. Conservative measures include medication such as anti-inflammatories or pain medications, rest, cortisone injections, and or physical therapy. All of these methods can be effective in helping relieve a painful shoulder especially when they are performed in combination with each other.

Often times when you present to your medical doctor with complaints of shoulder pain they will prescribe some medication as described above. It is easy to recommend that a person rest the painful shoulder but it may be difficult to do depending on their occupation or responsibilities at home. Injections for the painful shoulder are sometimes given right away depending on your medical doctor’s philosophy. Some MD’s would rather you attend physical therapy before considering injecting the painful shoulder. Injections are not the end all beat all and they do not offer relief to all patients that receive them. Often times a well rounded physical therapy program can alleviate shoulder pain and you won’t have to consider having an injection.

Physical therapy treatment can consist of the following interventions:

1. Therapeutic exercises: this will consist of range of motion, conditioning, and strengthening exercises. The goal here is to maximize and restore any loss of range of motion, improve the overall endurance of the shoulder blade and shoulder muscles and to improve the strength of these same muscles. Adequate strength of the shoulder blade muscles is just as important as having strong rotator cuff muscles. These two groups must work together in order to restore normal biomechanics and to prevent further injury.

2. Manual therapy: this will consist of hands on treatment that the physical therapist would perform on you. This might consist of joint mobilization (i.e. techniques designed to improve joint motion and relieve pain), or soft tissue massage (i.e. techniques designed to improve muscle and connective tissue flexibility and to relieve pain).

3. Modalities: this consists of machines that the physical therapist may apply to your painful shoulder to assist in pain relief and healing along with the other treatments mentioned above. Some of these machines are ultrasound, electrical stimulation, TENS, or iontophoresis.

All of these interventions can be used in the treatment of a painful shoulder. It is common in clinical practice to use a combination of these interventions. It has been my experience in treating hundreds of shoulder patients over the years that therapeutic exercise is an absolute in the treatment of the painful shoulder. Well rounded exercises that target the shoulder blade and shoulder muscles are the mainstay of any good physical therapy regimen for the treatment of shoulder pain. A painful shoulder can persist for years. With the right education you won’t have to suffer any longer!

Use ice to decrease pain

Shoulder Pain Treatments: Steroid Injections

Help for shoulder pain

Steroid injection represents a useful tool in the management of chronic shoulder pain. Ideally, steroids should be thought of as providing temporary relief. When injections are used appropriately, and in conjunction with physical therapy, they can serve as a sort of Band-Aid for the shoulder pain. In this way, steroids will give people a temporary period of time in which physical therapy can really start working. This is because steroids act as an effective anti-inflammatory, which will relieve the pain that is caused by normal use of the joint.

If a doctor deems steroid injections to be of use to the patient, they will typically use a lateral approach to inject the subchromial space, particularly with rotator cuff problems. At different times, the doctor may use an anterior approach or a posterior approach to actually put steroid into the shoulder joint. To conduct these straight injections would be less common though.

Steroids have multiple actions. As an anti-inflammatory agent they frequently will reduce pain in an area affected with inflammation. Also, and essentially a side effect is that, they will cause destruction of protein.

This means that steroid injections do include a risk of complication, and it is possible to get too many steroid injections into a shoulder. Where previously it was unknown as to the exact number of injections which equated this “too many”, recently, there has been research to suggest that if someone were to get more than 3 steroid injections into the shoulder, it could make the subsequent rotator cuff repair surgery more difficult.

When it comes to making a decision with regards to the use of steroid injections, one should realize the possible benefit of the drug when it is used appropriately. When used in conjunction with physical therapy, they can be a very effective tool in alleviating shoulder pain. Further, the doctor will perform the steroid injection under sterile conditions as to not introduce germs into the joint space, which further decreases the chance that a problem will arise. One should also consider the fact that steroids are actually created naturally in the body before the simple fear of the injection causes them to discard the treatment.

The steroids injected into the joint are generally safe and do not have the systemic side affects normally associated with steroid pills. For those concerned, steroid injections typically will not increase blood sugar levels to a significant degree.

However, possible side affects/adverse affects of shoulder steroid injection would include bleeding into the joint if the needle goes through a significant blood vessel, an infection, and skin ulcerations if too much is injected closely underneath the skin. Another side affect could be a “dent” that is formed where the steroid was injected. Additionally, there can be tendon rupture and overall weakening of the structure receiving the steroid.

Use ice to decrease pain