The following are the most important diseases or complications that can be caused by frozen shoulder: Musculoskeletal system and connective tissue (M00-M99). Movement restriction/restraint Cervicobrachial syndrome (synonym: shoulder-arm syndrome) – pain in the neck, shoulder girdle, and upper extremities. The cause is often the compression or irritation of spinal nerves (spinal cord nerves) of the … Frozen Shoulder: Subsequent Diseases
Staging of frozen shoulder Stage Description I (initial phase) Increasing pain at rest and on movement II (stiffening phase) Diminishing pain at rest; increasing limitation of mobility of the shoulder joint III (solution phase) Hardly any pain; fully developed frozen shoulder that improves over time (months to years)
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Shoulder region [signs of inflammation, hematoma (bruise), scars; swellings; atrophies; deformities (shoulder, thorax, spine); axial misalignment, asymmetries; scapula (shoulder blade) elevation] Palpation (palpation) of the shoulder girdle [local pressure … Frozen Shoulder: Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Inflammatory parameters – CRP (C-reactive protein).
Therapy target Pain relief and thus improvement of mobility. Therapy recommendations Analgesia (pain relief) according to WHO staging scheme. Non-opioid analgesic (paracetamol, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. If necessary, anti-inflammatory drugs / drugs that inhibit inflammatory processes (non-steroidal anti-inflammatory drugs, NSAIDs), eg … Frozen Shoulder: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Sonography (ultrasound examination) of the shoulder – to examine the rotator cuff, subacromial bursa/bursa subdeltoidea and biceps tendon. X-rays of the shoulder, in three planes – if necessary, evidence … Frozen Shoulder: Diagnostic Tests
Surgical intervention is indicated if symptoms worsen despite intensive physiotherapy or fail to improve. Usually, arthroscopic arthrolysis (minimally invasive circular opening of the shoulder joint capsule) is then performed. The aim of the measures is to eliminate the irritation or adhesions in the periarticular tissue of the shoulder and to restore the active and passive … Frozen Shoulder: Surgical Therapy
The following symptoms and complaints may indicate frozen shoulder (frozen shoulder): See also under classification: staging of frozen shoulder. Idiopathic frozen shoulder typically progresses in three stages: Freezing phase (freezing phase): Sudden, rapidly progressive pain in the shoulder joint (mainly at night), radiating to the insertion of the deltoid muscle. Movement restriction Duration 10-36 weeks … Frozen Shoulder: Symptoms, Complaints, Signs
Pathogenesis (development of disease) A primary form of frozen shoulder can be distinguished from a secondary form. The pathogenesis of the primary form is unknown. The primary (idiopathic) form of this disease is understood to be the cyclic clinical picture of capsular frozen shoulder. It is currently discussed to be related to the following conditions: … Frozen Shoulder: Causes
General measures The arm should be spared, i.e., pain-inducing abduction (moving body parts away from the body axis) and roatation movements should be avoided. However, sparing does not mean immobilizing! This could lead to stiffening of the shoulder (shoulder contracture). Local cold packs for pain relief Conventional non-surgical therapy methods Anesthetic mobilization: forcible release of … Frozen Shoulder: Therapy
Medical history (history of illness) represents an important component in the diagnosis of frozen shoulder. Family history Are there any bone/joint conditions in your family that are common? Social history What is your profession? Do you work physically hard in your profession? Current medical history/systemic history (somatic and psychological complaints). When does the pain occur? … Frozen Shoulder: Medical History
Musculoskeletal system and connective tissue (M00-M99). Rotator cuff rupture – tear of the muscle cuff involved in the shoulder joint [rotator cuff: supraspinatus muscle, infraspinatus muscle, teres minor muscle, and subscapularis muscle]. Tendinosis calcarea (calcific shoulder) – calcification mostly in the area of the attachment tendon of the supraspinatus muscle; prevalence (disease frequency): about 10% … Frozen Shoulder: Or something else? Differential Diagnosis