Frozen Shoulder Treatment

Best Frozen Shoulder & Adhesive Capsulitis Treatment In Malaysia

Overview of frozen shoulder treatment through advanced methods. Understand the cause and types of shoulder pain. Contact a CSC center near you for more information today.

shoulder pain due to frozen shoulder

Frozen shoulder (FS), sometimes called adhesive capsulitis, is a common shoulder condition that results in significant pain and loss of shoulder mobility. Sufferers often report shoulder stiffness in the early stages of this condition. Neglect of a stiff shoulder often leads to additional symptoms that include an inability to lift the arm to shoulder levels.

The clinical teams of Chiropractic Specialty Center® are the experts you need for non-invasive recovery and repair of the damaged shoulder joint or tissues. The care you get from our chiropractors and physical therapists is through manual and modality rendered procedures.

The combination of advanced therapeutic devices and targeted hands-on treatments of frozen shoulder syndrome (FSS) is the reason why our patients recover faster. So, if you are not keen on having injections or surgery for a frozen shoulder, visit one of our centers today.

Before going over our shoulder treatment methods, it may help many to discuss the issues that cause a frozen shoulder (FS) along with complications and its co-conditions. The most common question we get from our frozen shoulder patients is how did they get it. As mentioned, frozen shoulder is a loose term used to describe shoulder symptoms (FSS) such as shoulder pain and stiffness resulting in loss of mobility. A frozen shoulder develops when shoulder muscles and tendons are irritated, inflamed, damaged, or torn in the most basic terms. Initially, there is some pain or discomfort. But, some with mild shoulder injuries or damage may never experience any symptoms at all.

Before we get to an in-depth discussion or frozen shoulder, let’s go over some of the causes that lead to shoulder pain.

What Are The Common Causes Of Shoulder Pain?

Thoracic outlet syndrome, rotator cuff injuries, shoulder impingement syndromes, neck pain, slip-disc, upper back pain, and pinched nerves are common causes of shoulder pain. Shoulder pain is more common than most think it is. It is a common health issue that causes loss of sleep, anxiety, and even depression. What is worse is that many centers are ill-equipped or poorly skilled in proper diagnosis and proper treatment of shoulder pain.

The pain in your shoulder could result from wear and tear of the soft tissues (muscles, tendons, and ligaments) surrounding the shoulder joint. In addition to the soft tissues, the joint capsule and joint lining could produce severe pain. A slipped disc, spondylosis, bone spurs in the neck and degenerative discs disease are all known causes of shoulder pain. Complete recovery from shoulder pain is possible with targeted treatment that eliminates the actual cause of pain. If you have shoulder pain, visit Chiropractic Specialty Center® today for the best non-surgical shoulder pain treatment in Malaysia. Trust our experts, experience, advanced therapeutic technology, and non-invasive methods for faster recovery.

Is Adhesive Capsulitis & FSS The Same?

adhesive capsulitis in frozen shoulder

A common misconception amongst patients and some clinicians is that adhesive capsulitis is the same as FSS (frozen shoulder syndrome). Although these terms are interchangeable, there are differences. In other words, they may describe similar symptoms, but the actual cause may be entirely different. As such, we believe that adhesive capsulitis differs from the FSS, and here is why:

Adhesive capsulitis is descriptive of issues resulting from the shoulder joint’s degenerative changes, specifically, the shoulder capsule.

FSS, on the other hand, is usually a condition that results from damage or degenerative changes that occur near or in proximity to the shoulder joint. Often, these are the changes seen in the shoulder muscles and tendons. FSS usually results from damage and injury resulting in degeneration, inflammation, or tears of the rotator cuff muscles or tendons. Since the damage is not in the joint or involving the joint capsule, a frozen shoulder is classified as secondary adhesive capsulitis. We have discussed both the primary and secondary causes of adhesive capsulitis in greater detail in the subsequent sections.

What Causes Adhesive Capsulitis?

As mentioned, adhesive capsulitis and FS (frozen shoulder) are terms used interchangeably. There are differences as to the actual cause. However, the jury is still out on the actual cause of adhesive capsulitis and frozen shoulder. Some report it as an associated disorder to an autoimmune disorder. Most believe it to be due to an inflammatory process within the joint capsule.

Others relate it to muscles, tendons, and inflamed bursae of the shoulder griddle. But, the reality is that they all have merits. However, the most common cause of most FS or adhesive capsulitis is irritation or damage to the attaching soft tissues (ligaments, muscles, and tendons) and bursae (inflamed bursa or bursitis).

The shoulder joints are held together with attaching ligaments. Mobility is through the shoulder muscles and tendons. The bursa acts as lubricant and spacers for the tendons and muscles that surround the shoulder griddle. Irritation, damage, or injury at any of these tissues can lead to degenerative change that produces inflammatory processes, decreased mobility, and pain. If we break the term and look at them separately, it may become easier to understand:

  • “Capsulitis” is an inflammatory process of the capsule of the shoulder socket.
  • “Adhesive” is a term denoting sticking, cementing, or gluing together.

Therefore, adhesive capsulitis, as it stands, is an inflammatory process that impacts the shoulder joint. In other words, the traditional or primary form of adhesive capsulitis is damage to the shoulder joint and shoulder socket. Muscle injury and tendon tears are secondary forms of adhesive capsulitis, as seen in the rotator cuff issues. Let’s repeat that primary adhesive capsulitis is related to disorders within the joint capsule. Secondary adhesive capsulitis arises from rotator cuff issues or bursitis.

What Is The Role Of Damaged Joint Ligaments In Adhesive Capsulitis?

damaged shoulder capsule and ligament cause of frozen shoulder

Joints are encapsulated. The term encapsulated as it pertains to joint addresses the soft tissues surrounding, enclose, or envelops a joint securely. The articulations in your shoulder are held firmly in place by the shoulder joint’s capsule. This capsule is a collection of tissues and ligaments that firmly holds the joint together.

The innermost parts of the shoulder capsule contain a membrane called the synovium. The synovium houses the synovial membrane is filled with synovial fluids. Synovial fluids are the needed liquid for lubrication and sustenance of cartilage and tissues within the shoulder joint.

Direct or indirect traumatic events will impact the encapsulating tissues. It can lead to degenerative changes in the encapsulating ligaments.

These degenerative changes are the leading causes of primary adhesive capsulitis, better known as the frozen shoulder. The degenerative changes associated with a frozen shoulder or primary adhesive capsulitis result in the thickening of ligaments that hold the glenohumeral joint together. Hypertrophy is the term used to describe the thickening in ligaments. In short, hypertrophies are scar tissues or adhesions. These adhesions in the shoulder joint create pain, stiffness, and an eventual loss of motion. In time, the shoulder losses the mobility it once had.

Conditions that lead to the thickening of the shoulder capsule will cause a decrease in the production and availability of synovial fluids. With decreased synovial fluid production, the joint degenerative, and tissues start to break or tear apart within the joint. The change will impact joint mobility significantly. Pain can be severe and excruciating. Daily activities such as brushing teeth, combing the hair, or just putting off a shirt become a daunting task.

What Are The Common Symptoms Of Adhesive Capsulitis?

shoulder ranges of motion and causes of pain shoen

Loss of mobility and pain with shoulder movements are classic symptoms in the frozen shoulder (adhesive capsulitis). As mentioned, a frozen shoulder is often caused by either injury or degenerative changes over time. Some believe the common cause could be spontaneous, but we disagree. Any symptoms or pain you experience have a purpose or reason. In the so-called spontaneous cases, premature degenerative changes are the leading factors.

Adhesive capsulitis development may also be due to a secondary condition, including neck issues, upper back issues, rheumatoid diseases, heart disease, adrenal issues, thyroid problems, and even recent shoulder surgery.

Yes, if you have had a frozen shoulder after shoulder surgery, you are not alone. It is somewhat familiar and often implicated as a leading cause of primary adhesive capsulitis. The degree of damage and severity are often linked. A common complaint is that frozen shoulder patients are lack sleep. Lack o sleep is usually due to severe pain that wakes you up in the middle of the night.

As it progresses, other motions may also become difficult. In chronic cases, rotational movements are limited or absent. An inability to grasp the top of the opposite shoulder or reaching behind (internal rotation) is a common occurrence in neglected cases. Frozen shoulder or adhesive capsulitis symptoms are often linked to the shoulder’s ball-and-socket joint but can implicate other joints of the shoulder.

How Many Joints Are There In The Shoulder?

muscles of the neck, shoulders, and upper back

The shoulder is the most mobile joint in the body. No other articulation has the same or similar ranges of motion as the shoulder does. The shoulder’s increased mobility is due to its shallow joint surfaces, encapsulating ligaments, and of course, the muscles that provide mobility. Another reason for increased mobility is the number of joints that allow for this motion. The shoulder joint is not a singular joint but a series of four joints working collaboratively to provide the mobility we need daily.

We have submitted a brief list of these joints below for your review:

    1. The Glenohumeral Joint: The shoulder joint is a shallow ball-and-socket” joint that forms when the ball of the shoulder bone (humerus) sits or rests in the cup-like surface of the shoulder blade (glenoid fossa of the scapula).
    2. AC or Acromio-Clavicular Joint: The clavicle is the collarbone. It connects to the sternum at the midline and the scapula’s tip (Acromion Process) at the shoulder joint.
  1. The Sterno-Clavicular Joint:  The joint formed between the breastbone (sternum) with the collar bone (clavicle).
  2. Scapulothoracic joint: The scapulothoracic joint is formed by the shoulder blade (scapula) meets or comes close approximation to the ribs in the upper back.

Are There Different Types Of Adhesive Capsulitis?

There are two main categories of frozen shoulder or adhesive capsulitis:

  • Primary Frozen Shoulder (True Adhesive Capsulitis)
  • Secondary Adhesive Capsulitis or Frozen Shoulder (True Frozen Shoulder)

As mentioned numerous times before, frozen shoulder and adhesive capsulitis are interchangeable terms with differences in etiology. We mean that while there are many similarities, they differ in the actual cause.

What Causes Primary Adhesive Capsulitis?

women with painful left shoulder

Primary or true Adhesive Capsulitis is a condition related to other diseases. In other words, another health condition was the reason why adhesive capsulitis emerged. The most common co-conditions that could result in adhesive capsulitis include autoimmune disease (such as rheumatoid arthritis), diabetes, heart disease, stroke, Parkinson’s, hypothyroidism, lung diseases, and even shoulder surgery or neck dissection. Published research reports the prevalence of adhesive capsulitis at 20% in patients with diabetes. Patients with primary adhesive capsulitis (secondary frozen shoulder) will complain of pain and loss of mobility.

The classic differentiating symptom between the primary and secondary forms of frozen shoulder is the loss of rotation. Primary adhesive capsulitis, patients will initially present with limitation in external rotation. However, patients with true FSS (Frozen Shoulder Syndrome) or secondary adhesive capsulitis often complain of loss of internal rotation initially.

What Are The Causes Of True FSS Or Secondary Adhesive Capsulitis?

limited shoulder mobility revealed during chiropractic assessment

The secondary adhesive capsulitis or “true frozen shoulder syndrome” (FSS) is often due to damage or degenerative changes in the major shoulder muscles and tendons of the rotator cuffs. Conditions such as rotator cuff tears, bursitis, tendonitis, or bone spurs (Acromio-Clavicular spurs) are common causes of secondary adhesive capsulitis or a “true frozen shoulder syndrome” or FSS.

The rotator cuffs are a group of four muscles that help mobility and keep the shoulder joint stable. The four significant mobilizers or stabilizers of the shoulder are:

  1. Supraspinatus muscle
  2. Infraspinatus muscle
  3. Teres minor muscle
  4. Subscapularis muscle

Of the four muscles, the supraspinatus muscle and its tendon is the most commonly injured tissue. The supraspinatus tears are usually seen at the tendinous attachment to the greater tubercle of the humeral head. Often, the cause of this tear is an enlarged bone spur at the AC joint (acromioclavicular joint). As mentioned, the rotator cuffs are responsible for shoulder mobility and stability. These four muscles are the primary abductors (lifts the arm), internal rotator, and external rotator of the shoulder. For most patients, minor or initial tears of the rotator cuffs are painless. As such, it often goes undetected. However, as it progresses, it can cause symptoms.

How Is The Primary Adhesive Capsulitis Differentiated From A Secondary Adhesive Capsulitis Or FSS?

Healthy shoulder movement

Again, there are differences between primary and secondary forms of adhesive capsulitis. The secondary adhesive capsulitis or the “true frozen shoulder syndrome” (FSS) is related to damage, irritation, or injury of the rotator cuffs, bursae, or emerges for arthritic changes in the associated shoulder joints.

Although similarities are significant, our expert non-surgical clinical teams use various means to distinguish the differences. Identifying the actual cause of shoulder pain is a critical step in recovery. In other words, it is imperative to distinguish primary adhesive capsulitis from a secondary or the “true frozen shoulder syndrome” or FSS.

Earlier, we mentioned that patients with a true FSS would present with limitations in internal rotation, and those with primary adhesive capsulitis often have limitations with external rotation. There is another sign to help distinguish the two. A “true frozen shoulder” patient will present with difficulty in the passive abduction and internal rotation. Shoulder abduction is the motion where you lift your shoulder sideways, towards the head and neck. Internal rotation is where one tries to reach behind — an active range of motion, one where the patients attempt movements. Passive ranges of motion are fully assisted movements. In other words, the patient remains still while the clinician or therapists move the arm.

In short, the loss of passive ranges of motion is the classic sign of a “true frozen shoulder syndrome” (FSS), better known as secondary adhesive capsulitis. On the other hand, the primary adhesive capsulitis patient will have difficulty in both active and passive motion ranges. Another means of differentiating the cause is through diagnostic imaging. The best modality to diagnose adhesive capsulitis is the MRI.

MRI Or Magnetic Resonance Imaging Is The Gold Standard In Shoulder Assessment

X-rays and diagnostic ultrasound have had some successes in the assessments of shoulder pain. But, none has proven as helpful as the MRI. Magnetic Resonance Imaging (MRI) can detect tears in muscles or tendons. It is also the best modality in assessing bone spurs, cartilage, joint capsule, ligaments, and even pathology. In short, if you have shoulder pain that won’t go away, you should ask your doctor for MRI.

The chiropractors and physiotherapists of Chiropractic Specialty Center® are the best non-surgical experts for diagnosing and treating shoulder pain. Our clinical teams have the knowledge needed to identify the actual cause of your shoulder pain.

In our center, a Doctor of Chiropractic will thoroughly assess your shoulder. We will also evaluate your neck, upper back, and chest (ribcage) to identify the cause before treatments. Often, there are multiple causes. Recovery is possible with our targeted care that addresses the actual cause. The care you get from us is through the best chiropractors in KL and physiotherapists in Malaysia. Our care and treatment method for a frozen shoulder will get you back to an active life faster. Call us now.

Best Homecare For Shoulder Pain & Frozen Shoulder

The first thing you will need to do is to limit any aggravating activity. You will also need to get a sling. Get a simple shoulder sling. The goal of a sling is to protect the joint and its soft tissues from further damage. Some may find it helpful to wear the sling during sleep. Please follow other dos and don’t’s of shoulder pain treatments as they are essential to a speedy recovery. Aside from taking it easy, resting, and getting a sling, we have put a list of what you can do at home to help your recovery from frozen shoulder pain:

  1. Ice the affected: Icing will help reduce the swelling. Shoulder pain caused by primary and secondary adhesive capsulitis cause an inflammatory reaction. To speed healing and prevent further damage, icing the painful areas every two to three hours for 15-minutes will help. Remember to wrap the ice pack in a cloth. Never put the ice pack directly on the skin. And always ice less than 20-minutes and not sooner than once every hour.
  2. Do gentle, painless range of motion exercise: Try moving your arm around, but avoid the painful ranges. Movements should not cause pain. If painful, avoid the range of motion exercise. And always ice the painful areas of your shoulder after stretching or an exercise session.
  3. Contact us: Once you have done all of the above self-help homecare remedies, call our office. Let our expert chiropractors and physiotherapists assess your shoulder thoroughly. It would help if you never ignored a painful shoulder. We can help

Chiropractic SPecialty Ceter® provides the best non-invasive shoulder treatment. Contact our chiropractor today. We have the top evidence-based chiropractors in Malaysia.

What Is The Best Treatment For Adhesive Capsulitis or FSS?

man with shoulder pain

Spine, joints, and sports injuries are best treated through conservative methods. For conservative treatments to work, you must target care to tissues damaged or irritated. Adhesive capsulitis or FSS (frozen shoulder syndrome) treatments depend on the actual cause.

Both primary and secondary causes of adhesive capsulitis need conservative treatment. However, primary adhesive capsulitis patients will require care from other specialists in tandem with the treatments we provide. Our clinical physiotherapists and advanced chiropractors will inform you of this need should it arise.

In both the primary and secondary forms of frozen shoulder, the shoulder joint’s soft tissues, joints, and cartilage are affected. The care you get from us will address these issues through physiotherapy, targeted chiropractic treatments, and supplements. Depending on the cause and severity of the damage, our clinical teams may use shockwave therapy, ultrasound, electrical stimulation, myofascial release, trigger point therapy, or targeted exercise rehabilitation. In most cases, we use several methods to address the underlying issues.

The hallmark frozen shoulder is the loss of mobility. With decreased mobility, the shoulder joint weakness. This weakness will result in degenerative changes and tears in critical tissues. Our goals are to identify and correct them without injections or surgery. In short, if you are not keen on having shoulder injections or shoulder surgery, visit a Chiropractic Specialty Center® near you today. Our center provides holistic, non-invasive frozen shoulder treatment without injections or surgery in Malaysia.

This Post Has 2 Comments

  1. Linda

    Any hope for a frozen shoulder plain?

    1. Yama Zafer, D.C.

      Dear Linda,
      Thanks for posting a comment. Frozen shoulder results from injuries and degenerative changes that occur in the shoulder joints. The shoulder has two main joints: The acromial-clavicular joint (A/C joint) and the glenohumeral joint (the true shoulder joint). Injuries and degenerative changes in these joints and their soft tissues (muscles and ligaments) lead to pain and an inability to move shoulders freely.

      Also, patients with a frozen shoulder may have issues in their neck and upper back. Neck pain and upper back pain (pain between the shoulders) are common in frozen shoulder patients as some muscles attach to the neck, upper back, and shoulders.

      To recover, you will need care that focuses on the root cause of your pain. As such, a thorough assessment of the shoulder joint and your neck and upper back are needed. Identification of the exact cause of pain is essential to complete recovery. Our clinical teams of chiropractors and physiotherapists have the knowledge and skills to assess and provide you with the best holistic treatment. I invite you to call our center at 03 2093 1000 for more information about our shoulder treatment programs.

      I hope this helped.

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