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Frozen shoulder (adhesive capsulitis)

Treatments for arm and shoulder problems, orthopedic issues of the arm or the shoulder.
The syndrome of the “frozen shoulder”, concerns the shoulder’s long-standing pain and stiffness. The etiology of the syndrome is considered to be unknown and usually, after a period of 6-24 months there is improvement of the abnormal situation. With regard to the radiologic aspect, the syndrome is described by a narrowing of the joint space and pathologically, is the thickening of the synovial bursa, adhesions and decrease of the synovial fluid.

At least, this is what we’ve learned as orthopedic surgeons. In all these years that we are examining patients, we have not come across this entity called frozen shoulder.
We came across stiffness and pain of the shoulders, which, however, always had some medical explanation. Today, we believe that the pain and stiffness of the shoulder except for the cases of inactivity after injury, is due, if there is no arthritis, to disorders of the nerves of the upper limb.

The carpal tunnel syndrome causes nocturnal arm numbness (numbness) and a feeling of heaviness of the arm. In syndromes that hadn’t been treated, we observe that patients also present ulnar neuritis. These problems affect the mobility of the upper extremity.

The stiffness of the shoulder is due to this reduced mobility, and as a result of this, after some time, the problem of the shoulder becomes more acute than the nerve issue, and finally the sufferer visits the doctor for the problem on the shoulder instead of the one concerning the nerves.
Furthermore, due to the immobility of the shoulder, the symptoms of the nerve condition subside and if the doctor is not experienced, he/she won’t be able to notice them. In conclusion, every patient who reports the syndrome of the frozen shoulder, if there is no previous injury with resultant immobility, or arthritis, should be examined carefully for the carpal tunnel syndrome and ulnar neuritis.

The treatment for the frozen shoulder is the Intra-articular drug delivery and kinisiotherapy in parallel. When the shoulder is healed, the patient must be re-examined for coexisting nerve diseases.

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