What is a frozen shoulder?
Frozen shoulder is a disease that occurs in three stages: 1) First, inflammation occurs in the shoulder. 2) In the further course, the affected person notices an increasing restriction of movement (therefore also called “freezing”). 3) In the further course, appropriate therapy can help to reduce the inflammation and improve mobility (“onset of freezing”).
What are the symptoms of those affected?
Those affected often suffer from permanent pain, which also occurs at night and disturbs sleep. Accordingly, sufferers position themselves on one side, which places additional stress on the shoulder. Imaging procedures such as sonography (ultrasound), X-rays and magnetic resonance imaging are therefore necessary for clarification.
In addition, the patients hardly move the arm due to the severe pain, so that there is an increasing shrinkage of the capsule and a frozen shoulder sets in.
What are the treatment options?
Initial treatment with inflammation-reducing medication and often also with cortisone (in the form of an injection or medication) is necessary at an early stage. Only when the acute pain symptoms have subsided is physiotherapeutic exercise treatment advisable.
If necessary, surgery can also help with frozen shoulder. This involves arthroscopy to remove inflamed tissue and also to loosen adhesions. Each anesthesia is followed by anesthesia mobilization, which may be followed by intensive physiotherapy.
What does therapy depend on?
Um den Schweregrad der Schulterverletzung richtig zu bestimmen, wird eine Klassifikation (nach Tossy/ Rockwood) vorgenommen. Die Zuteilung bestimmt dann die entsprechend passende Therapie, die bei der Verletzung notwendig ist. Man unterscheidet in folgende drei Typen:
Tossy/ Rockwood I – The AC joint is compressed, the capsule overstretched. The bones and especially the clavicle do not shift under load. Conservative therapy is used in this case.
Tossy/ Rockwood II – Es handelt sich um eine Teilruptur der Gelenkkapsel und der akromioklavikularen Bänder. Auch in diesem Stadium kann konservativ behandelt werden.
Tossy/ Rockwood III – Complete rupture of capsule and ligaments with horizontal and vertical instability. Since the so-called coracoclavicular ligaments are completely torn, the clavicle is significantly higher compared to the acromion (shoulder roof). Successful treatment can only be achieved surgically.