With a sometimes undeciphered origin, patients experience shoulder pain at a level and frequency that quickly becomes unmanageable. While shoulder pain can be a result of several risk factors – low, high, and everywhere in between – at times, the diagnosis of shoulder pain is not what matters to patients.
There are times when patients experience a level of pain in their shoulders that causes them to only care about the treatment for the pain and whether that treatment is safe and effective. Before patients seek any treatment for their shoulder pain, it is imperative that they are diagnosed with the underlying cause of the pain.
If a patient has not been diagnosed concerning the origin of their shoulder pain, it is possible that the treatment they undergo will not only be unhelpful but could exacerbate their condition. In addition to being diagnosed with the correct condition, patients may also meet complications with prescribed treatments.
Understanding and educating oneself on the origin of shoulder pain and the treatment that will help the most is a significantly important part of the process because it will result in the best treatment possible for the patient.
Patients may also take comfort in knowing that they are not the only ones attempting to address their shoulder pain. Often, however, they will be met with several results to scroll through online. However, before patients attempt to self-diagnose the condition of their shoulder pain, it is recommended that they seek the opinion of a medical professional.
This article will be covering one of the most common conditions of shoulder pain, more commonly known as a frozen shoulder. We hope to shed light on this common condition and how it can be effectively treated.
If you are experiencing the debilitating symptoms of a frozen shoulder, such as severe pain, limited range of motion, and reduced quality of life, it is crucial to explore viable treatment options.
Among these options, platelet-rich plasma (PRP) therapy emerges as a highly effective and safe treatment choice. PRP therapy harnesses the healing power of your body’s own platelets to alleviate pain and promote tissue repair, offering hope for significant pain relief and improved shoulder function. We hope to provide you with valuable insights into PRP treatment for frozen shoulder and discover the potential it holds for restoring your quality of life.
The Prevalence Of Shoulder Pain In The Population
Physicians have been tracking the prevalence of patients seeking shoulder treatment for decades.
As early as 2005, Dr. Caroline Mitchell and her associates found that “[s]elf reported prevalence of shoulder pain is estimated to be between 16% and 26%; it is the third most common cause of musculoskeletal consultation in primary care, and approximately 1% of adults consult a general practitioner with new shoulder pain annually.” (2005)
With that in mind, patients can be sure that as they seek treatment, they will likely know someone else who has suffered from or is currently seeking treatment for their shoulder pain.
How Common Is A Frozen Shoulder?
The condition of a frozen shoulder is a common problem that affects a considerable number of people. In a 2019 study assessing both the diagnosis and treatment options for this disorder, Dr. Cho from the Clinics in Orthopedic Surgery summarized that “[f]rozen shoulder (FS) is one of the most common yet challenging clinical disorder[s] presenting to the orthopedic surgeon.
“It is a disease characterized by a significant decrease in the active and passive range of motion (ROM) of the glenohumeral joint, along with pain. The prevalence rate of FS is 2%–5%, and it occurs more commonly in women. Along with the increase in comorbidities and changes in lifestyle, the incidence of FS is increasing.
“But FS’s natural course and pathogenesis have not been widely investigated and are still unknown.” (2019)
While this condition may infect a small percentage of the population (2% -5 %), it is a relatively large percentage of those suffering from shoulder pain (between 16% -26 %) in the first place.
When considered, these percentages indicate that approximately 25% of those with shoulder pain could be experiencing a frozen shoulder.
The exact cause and natural progression of a frozen shoulder are still not fully understood. However, it is essential to recognize that the impact it can have on individuals can be significant, with sufferers commonly experiencing near-constant shoulder pain. By exploring the nature of a frozen shoulder, we can better understand its symptoms, causes, and available treatment options.
What Is A Frozen Shoulder?
A frozen shoulder is a condition that causes significant pain and stiffness in the shoulder joint. It is characterized by a gradual loss of range of motion, making it challenging to perform everyday activities.
When a shoulder is “frozen,” the connective tissue surrounding the joint, known as the capsule, becomes thickened and tight. This restricts the movement of the shoulder, resulting in pain and stiffness.
To understand how a frozen shoulder develops, imagine the shoulder joint as a ball and socket. The ball is the upper part of the arm bone (humerus), and the socket is the shallow depression in the shoulder blade (scapula). The capsule is the structure that surrounds this joint, holding it together and providing stability.
In a frozen shoulder, the capsule and its connective tissue become inflamed and thickened. The exact cause of this inflammation is still not fully understood, but it can be triggered by various factors such as injury, trauma, or an underlying medical condition.
When the capsule of the shoulder begins to thicken, it can lead to the formation of adhesions, which are bands of scar tissue that further restrict the movement of the joint. This is what causes the symptoms of pain and stiffness, making it challenging to perform basic shoulder movements like reaching or lifting.
Understanding the development of a frozen shoulder is crucial in determining appropriate treatment approaches. Furthermore, comprehending the potential causes of this condition can guide treatments that best address the underlying factors or implement preventive measures to prevent its progression over time.
In the next section, we will explore the various factors that can contribute to the development of a frozen shoulder.
Causes Of Frozen Shoulders
When it comes to the cause of a frozen shoulder, although the exact underlying cause is not always clear, several factors have been identified as potential contributors to its development. These factors include:
- Instability: Shoulder instability, which can occur due to ligament or muscle damage, can lead to the development of a frozen shoulder. When the shoulder joint becomes unstable, it can trigger a protective response in the body, causing the surrounding tissues of the shoulder capsule to become inflamed and stiff.
- Dislocation: A shoulder dislocation refers to the upper arm bone coming out of its socket, causing damage to the surrounding tissues of the shoulder. This damage triggers inflammation and the formation of scar tissue within the shoulder capsule.
- Consequently, restricted shoulder movement, chronic pain, and the development of a frozen shoulder can occur as a result.
- Trauma: A traumatic event, such as a fall, accident, or repetitive overuse, can cause injury to the shoulder joint and its surrounding tissues. This injury triggers the body’s inflammatory response. If the initial injury is significant or inadequately healed, it can lead to the formation of adhesions.
- These adhesions are abnormal bands of scar tissue that can restrict shoulder movement and contribute to the development of a frozen shoulder.
It’s important to note that these causes do not apply to all cases of frozen shoulder, and each individual’s condition may have unique contributing factors. Consulting with a medical professional is crucial to determine the underlying cause and develop an appropriate treatment plan.
Furthermore, certain risk factors are linked to an increased likelihood of developing a frozen shoulder. These factors can exacerbate the chances of experiencing this condition. Let’s delve into and explore these specific factors that contribute to its development.
Risk Factors For Frozen Shoulders
While anyone can develop a frozen shoulder, these certain health and lifestyle factors can increase the risk of its occurrence.
- Age and sex: Frozen shoulder is more commonly observed in individuals between the ages of 40 and 60. Additionally, women are more prone to developing a frozen shoulder than men.
- Reduced mobility: Any condition or circumstance that limits the shoulder’s range of movement or immobilizes the joint for an extended period can increase the risk of developing a frozen shoulder. This includes prolonged bed rest, wearing a shoulder sling, or recovering from a surgery or injury that restricts shoulder movement.
- Past surgeries: Individuals who have undergone previous shoulder surgeries, such as rotator cuff repair or a shoulder joint replacement, may be at a higher risk of developing a frozen shoulder. The immobility and trauma associated with surgery can contribute to the development of adhesions and stiffness.
- Systemic and metabolic diseases: Certain metabolic conditions, including diabetes, thyroid disorders, heart disease, and autoimmune disorders have been found to be associated with a higher risk of developing a frozen shoulder.
- Although the precise mechanisms connecting these conditions to frozen shoulders are still being investigated, it is suspected that chronically elevated inflammation and increased lipids in the bloodstream seen throughout these disorders may play a significant role as contributing factors.
While these risk factors can make an individual more susceptible to developing a frozen shoulder, it’s important to remember that the condition can occur in the absence of these factors as well. Each case is unique, and a comprehensive evaluation by a healthcare professional is essential for accurate diagnosis and appropriate treatment.
How Is A Frozen Shoulder Diagnosed?
Diagnosing a frozen shoulder typically involves a combination of medical history assessment, physical examination, and medical imaging studies. It is typical that an expert healthcare professional, such as an orthopedic specialist, will be required to evaluate the symptoms and conduct specific tests to make an accurate diagnosis.
During the medical history assessment, the healthcare provider will inquire about the onset and progression of your symptoms, as well as any previous shoulder injuries or surgeries you may have had. It is important to provide a detailed account of the symptoms, including the level of pain, stiffness, and limitations in shoulder movement.
A physical examination commonly involves assessing the range of motion of the affected shoulder, both actively (by the patient’s own effort) and passively (by the examiner moving the shoulder). The healthcare provider will also palpate (touch) the shoulder to identify areas of tenderness and check for signs of swelling or inflammation.
While imaging studies are not always necessary for diagnosing a frozen shoulder, they can help to rule out other potential causes of shoulder pain and stiffness. It is common that X-rays are taken to evaluate the bone’s structure and rule out any abnormalities or degenerative conditions.
MRI imaging is occasionally used, and while it cannot definitively diagnose the condition, it can help identify any damage to the shoulder’s soft tissues, such as a rotator cuff tear, and rule out other possible causes of shoulder pain and stiffness.
The primary diagnosis of a frozen shoulder is typically based on the patient’s history and physical examination, with MRI merely playing a supportive role in cases where there is uncertainty or a need to exclude other pathologies.
Diagnosing a frozen shoulder can be challenging, since it shares symptoms with other shoulder conditions. In the following section, we will delve into this topic and provide a better understanding of the diagnostic complexities involved.
Why A Frozen Shoulder Is Hard To Diagnose
With a condition as prevalent as a frozen shoulder, patients might wonder why the pathogenesis and cause of the condition are still ambiguous. How can a condition so prevalent be less than properly understood?
Dr. Cho continues to evaluate the disorder and its pathogenesis by breaking it into stages and concludes that “[a]ccording to the research so far, FS can be divided into three phases: freezing (insidious onset of shoulder pain with progressive loss of motion), frozen (gradual subsidence of pain, plateauing of stiffness with equal active and passive ROM), and thawing (gradual improvement of motion and resolution of symptoms).”
Dr. Cho’s determination of the stages involved with FS shed light on the origin of the term “frozen shoulder” and might help patients who suffer from shoulder pain describe the condition to their doctors in order to determine an accurate diagnosis
While patients might assume that a frozen shoulder will “thaw,” as Dr. Cho colloquially suggests, the doctor also highlights why viewing the condition as transitory could be a mistake. Dr. Cho continues to suggest that “[t]raditionally, FS has been regarded as a self-limiting and benign disease with complete recovery of pain and ROM.
“However, this condition can sometimes last for years. In one study, 50% of patients were still experiencing pain or stiffness of the shoulder at a mean of 7 years from the onset of the condition, although only 11% reported functional limitation. Reeves, in a prospective study of 41 patients with 5 to 10 years follow-up, found that only 39% of patients had a full recovery.
“This long period of pain and disability deprives the patients of their routine life and occupational and recreational activities. Although appropriate treatment is needed for a rapid return to their own life, definitive treatment strategies have not been established, and many different management strategies are used.”
Of course, while physicians might not fully understand the origin and pathogenesis of frozen shoulder, this does not mean that they have not found ways to adequately maintain and assuage the pain. Now, let’s shift our focus to explore the conventional treatment options available for managing the symptoms of a frozen shoulder.
Traditional Treatments For Frozen Shoulder
Traditional treatments for frozen shoulder aim to manage the symptoms, reduce pain, and improve shoulder mobility. These treatments may include:
- Physical therapy: Physical therapy plays a crucial role in the treatment of frozen shoulder. It involves a series of exercises and stretches specifically designed to improve the shoulder’s range of motion, reduce stiffness, and strengthen the surrounding muscles. Physical therapists may also utilize manual techniques and modalities like heat or cold therapy to alleviate pain and promote healing.
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may be prescribed to reduce pain and inflammation associated with a frozen shoulder. In some cases, analgesic medications or muscle relaxants may also be used to alleviate discomfort and muscle tension.
- Steroid injections: Corticosteroid injections directly into the shoulder joint can provide significant temporary pain relief and reduce inflammation. These injections are best when administered under ultrasound to ensure accurate placement.
- Steroid injections may also temporarily improve shoulder mobility and provide a window of opportunity for physical therapy and rehabilitation. Due to their temporary nature, steroid injections often require repeat doses for effective treatment.
- Surgical release: In severe cases where conservative treatments fail to alleviate symptoms, surgical intervention may be considered.
- The surgical procedure, known as arthroscopic capsular release, involves releasing the tightened and thickened capsule to improve shoulder mobility. It is usually performed using an arthroscopic or “keyhole” surgical technique to ensure minimal tissue trauma and faster recovery.
It is important to note that the effectiveness of these traditional treatments can vary from person to person. Some individuals may experience significant improvement, while others may find limited relief. In recent years, alternative treatments like platelet-rich plasma (PRP) have emerged as a promising option for the management of frozen shoulder.
Platelet-Rich Plasma And Frozen Shoulder
While one could expect the typical painkillers and anti-inflammatory drugs to be prescribed for those who suffer from frozen shoulder pain, they might not consider alternative treatments that have been studied and determined to be effective.
Many novel treatments seem to have a positive impact on treating frozen shoulders, but some seem to have a negative impact. However, patients can take hope in one of these novel treatments that seems to have the maximum benefit with no side effects: the treatment of platelet-rich plasma for frozen shoulder.
Dr. Aslani, in the Archives of Bone and Joint Surgery, explains that “[p]latelet-rich plasma (PRP) is an autogenous concentration of human platelets in a small volume of plasma. Platelet-rich plasma development via centrifugation [spinning] has been greatly simplified so that it can be used in office settings as well as operating rooms.
“The use of PRP has increased, given its safety as well as the availability of new devices for outpatient preparation and delivery.” (2016)
As the efficacy of platelet-rich plasma in treating many conditions (including frozen shoulder) becomes apparent, it is only natural that this treatment will be requested and more easily implemented.
But if it is increasing in popularity, that must mean it has some efficacy, and if it has an evident efficacy in treating shoulder pain, one might wonder just exactly how it works.
How Does PRP Work For Frozen Shoulder?
Dr. Aslani continues to explain that “[p]latelet-rich plasma can produce collagen and growth factors and might increase stem cells, which consequently enhances the healing process by delivering high concentrations of alpha-granules containing biologically active moieties (such as vascular endothelial growth factor and transforming growth factor-β) to the areas of soft tissue damage[.]”
In short, platelet-rich plasma – when injected into the affected areas (i.e. the shoulder) – delivers growth factors and collagen to help repair damaged areas. Effectively, platelet-rich plasma assists in the body’s natural healing process. Dr. Aslani, knowing the process of application and efficacy of platelet-rich plasma, conducted the following study in order to determine its efficacy against FS.
She continues in her own words that “[a]s this method [PRP] has good results in the repair of tendons, muscles and ligaments and even fractures, and because there is no evidence of complications related to PRP injections and since we are not aware of the efficacy of the PRP injection on FS, we used PRP on a patient with FS.”
After testing PRP on a male patient with minimal comorbidities who suffered from FS, Dr. Aslani recorded that “[t]he average pre-treatment ROM [range of movement] was 70 degrees for flexion, 75 degrees for abduction, and 25 degrees for external rotation.
“After the first treatment, the patient reported 60% improvement in shoulder pain during the daytime, and 100% at night. After the second injection, post-treatment mean ROM value showed: 150 degrees of flexion, 135 degrees of abduction, and 50 degrees of external rotation.
“Also, the patient reported improvements more than 70% regarding his function based on the DASH questionnaire. He was also 70% satisfied with the treatment[.]”
According to this study, Dr. Aslani and her associates correctly determine that, “[t]he result showed improvement in the ROM of all directions and functional improvement of the patient.
Also, the result showed decreased pain during the daytime and complete pain improvement at night.”
What To Expect From PRP Treatment
When considering PRP treatment for frozen shoulder, it is essential to understand what to expect before, during, and after the procedure. The following is a general overview:
- Consultation: Before undergoing PRP treatment, you will have a consultation with a healthcare professional experienced in administering PRP therapy. They will evaluate your medical history, assess your shoulder condition, and discuss treatment goals and expectations.
- Preparation: On the day of the procedure, a small sample of your blood will be drawn. The blood sample will be processed in a centrifuge (spinner) to separate the platelet-rich plasma from other blood components. This concentrated PRP will then be collected and prepared for injection.
- Injection: Using a sterile technique, the healthcare professional will inject the PRP directly into the affected areas of the shoulder joint. They may use imaging guidance, such as ultrasound, to ensure precise placement of the injections.
- Recovery and rehabilitation: After the PRP injections, you may experience some mild soreness or discomfort at the injection site. It is essential to follow any post-procedure instructions provided by your healthcare professional, including rest, gentle shoulder exercises, and avoiding excessive strain on the shoulder joint
- Follow-up: Your healthcare professional will schedule follow-up appointments to monitor your progress and make any necessary adjustments to your treatment plan. The number of PRP treatments required may vary depending on the severity of your frozen shoulder.
It is important to note that the response to PRP treatment can vary from person to person. While some individuals may experience significant improvement after a single treatment, others may require multiple sessions to achieve optimal results.
Working closely with your healthcare professional will help determine the best course of treatment for your specific condition. While PRP therapy is an effective treatment for managing the painful symptoms of a frozen shoulder, it’s important to note that not all facilities offering this alternative treatment adhere to the same protocols.
It’s important to be aware that different facilities may follow varying protocols when it comes to PRP therapy for frozen shoulder. This highlights the need for seeking healthcare from a reputable provider who prioritizes safety and transparency and who aligns with your specific needs.
Finding a trustworthy healthcare provider is essential to ensure the best possible outcome for your PRP therapy experience.
Why Choosing The Right PRP Treatment Matters
When a patient’s range of motion is affected in their shoulders, hundreds of other physical tasks are sacrificed. With Orthagenex, patients with frozen shoulders can expect treatment with high-dose platelet-rich plasma.
With these injections being safe and effective, patients can be confident in knowing that their range of movement has the best chance of returning to normal. In addition to improved ROM, patients can find relief from frozen shoulder pain.
All of this is due to Orthagenex High Dose PRP, the most advanced platelet-rich plasma treatment available today, which facilitates the body’s natural capability and desire to heal itself from pain – even pain from conditions like frozen shoulders.
Orthagenex stands out in the field of PRP therapy for frozen shoulders by delivering a concentrated dose of platelets and growth factors directly to the affected areas. This approach promotes tissue repair, reduces inflammation, accelerates the healing process, and maximizes therapeutic benefits.
Additionally, what sets the Orthagenex clinics apart is our unwavering commitment to safety, efficacy, and patient satisfaction. Our clinics adhere to stringent quality standards and employ experienced healthcare professionals who specialize in PRP therapy.
Orthagenex understands the profound impact a frozen shoulder can have on a person’s quality of life, limiting daily activities and enjoyment. With years of combined experience and expertise in PRP therapy, Orthagenex aims to provide patients with effective and long-lasting relief from shoulder pain. Our goal is to help you regain your mobility and improve your overall well-being.
Choosing the right PRP treatment can make a significant difference in your frozen shoulder treatment’s success. By partnering with a reputable and specialized clinic, you can have confidence in the treatment’s safety, effectiveness, and expertise of the healthcare professionals involved.
How Does PRP Compare To Other Treatments?
While Dr. Aslani heralds and praises PRP as a new treatment for FS, she also chooses to single out a particular novel treatment that might have deleterious effects:
“Physicians usually recommend injections of corticosteroid and hyaluronic or physiotherapy for FS management, but such injections have some side effects, and physiotherapy has not shown a superior efficacy according to the literature. However, in this report, we have suggested a new effective intervention for improvement which seems to have no side effects [referring to PRP].”
With the results of their study in hand, Dr. Aslani and her associates are able to turn away from corticosteroid injections. They can conclude that “[t]he results of this study support the use of PRP in frozen shoulders.
“We found that PRP has positive effects on healing during shoulder capsulitis. This intervention decreases pain and increases upper limb function. Also, it can improve the range of shoulder motion in various directions.”
Seek Out The Best Treatment For A Frozen Shoulder
Patients with frozen shoulders should refrain from resorting to living with the condition and wait for it to thaw before freezing again. Living with this chronic condition does not mean patients need to accept a reduced quality of life or limited level of physical activity.
By seeking the most effective treatment for a frozen shoulder, you can effectively manage the condition, find relief, and regain control over your quality of life. While traditional treatments like physical therapy, medications, and surgery can offer some relief, it is important to consider alternative options that provide promising results without relying solely on long-term pharmaceuticals or invasive surgeries.
One such alternative is high-dose platelet-rich plasma (PRP) therapy. By exploring innovative approaches like PRP therapy, you can broaden your treatment options and potentially experience significant benefits in managing your frozen shoulder symptoms.
Choosing Orthagenex and its high-dose PRP treatment allows you to benefit from the expertise of experienced healthcare professionals dedicated to safety and efficacy. Our commitment to utilizing advanced PRP techniques and adhering to strict quality standards ensures the highest level of care and the best treatment outcomes.
With Orthagenex’s high-dose PRP therapy, you can regain shoulder mobility, alleviate pain, and improve your overall quality of life. Take the first step towards a pain-free and active lifestyle by reaching out to Orthagenex today.
Frozen shoulder should not keep you from living your best life