Frozen Shoulder with Dr. Jason Tarno

Las Vegas is a place where people of all ages tend to be very active. Tennis, racquetball, and golf are activities that many people enjoy even in their later years. In these sports the shoulder can become injured, and these athletes can wind up with a stiff shoulder. What is this stiffness and why does it occur?

Stiffness of the shoulder is known medically by the term adhesive capsulitis. This term refers to a tightening of the shoulder capsule that covers the shoulder joint. It was first described in the late 1800's, and is defined as a condition of the shoulder that is characterized by painful restriction of motion of the shoulder. It tends to affect women more commonly than men, and is seen most often in the fifth, sixth, and seventh decades of life. It can occur in either the dominant or non-dominant shoulder.

How is this different from “frozen shoulder?”

There is no difference. Both terms refer to the same disease process and are used interchangeably in the medical literature.

What are the causes of this type of shoulder stiffness?

Causes of adhesive capsulitis can be broken down into primary causes and secondary causes. In primary causes, the individual cannot identify a specific injury. Researchers are still attempting to identify the cause in these cases. Secondary causes stem from injuries such as fractures or rotator cuff injury. Other secondary causes stem from diseases such as thyroid disorder or diabetes.

Do x-rays show anything?

The diagnosis of adhesive capsulitis is really made on clinical exam. Painful range of motion with restriction of motion is the real key to diagnosis.

What is the treatment for this disorder?

Treatment consists of range of motion exercises. Physicians write a prescription for physical therapy, and the patient works closely with a therapist to increase their shoulder motion. The patient is monitored every four to six weeks for progress on their motion. If improvement is measured, then therapy is continued. If the patient seems to plateau or decrease their range of motion, a procedure called manipulation under anesthesia is performed.

What is manipulation under anesthesia?

The patient is taken to the operating room and given anesthesia to allow them to relax and to go to sleep. Once the patient is asleep, the orthopedic surgeon takes the arm and moves the shoulder through its range of motion to break down scar tissue. Once the patient awakens they are placed on medication for pain and they resume their physical therapy routine.

Are medications helpful?

Occasionally a steroid injection is offered to help with pain and inflammation. This also can aid in the progress of physical therapy. If the patient has diabetes, care must be taken in monitoring glucose levels, because steroid injections can elevate sugar levels.

How long does this problem usually last?

This disease process can last for as short as 6 months to as long as 2 years, and sometimes even longer. The key is to find a good physical therapist, to keep a positive attitude, and not to give up. Most patients do well with treatment.

- Jason M. Tarno, D.O., is Board Certified and Fellowship trained in Sports Medicine. Dr. Tarno is an associate of Crovetti Orthopaedics and Sports Medicine.

For further information call: 990-2290.

Or visit us at: www.CrovettiOrtho.com