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DMR Therapy® specializes in releasing the involved tissues manually rather than tearing or cutting them. The result can be much faster resolution to the problem without the usual side effects.

Frozen shoulder, sometimes identified as adhesive capsulitis, is a term used to identify a painful shoulder that exhibits extremely restricted range of motion and pain. This is normally caused by adhesions (stiff bands of tissue) that grow between the shoulder joint surfaces. The shoulder capsule thickens and becomes tight, restricting motion often to the degree that it can’t be moved on one’s own or with another person’s help.

Apart from the shoulder being “frozen”, adhesive capsulitis is characterized by the following:

  • slow-onset pain
  • pain is localized near the deltoid insertion
  • inability to sleep on the affected side
  • X rays of the area may appear normal
  • it may be self-correcting, though recovery might take from 2-3 years

CAUSES:

The cause of most frozen shoulder is poorly understood it is normally considered idiopathic (of unknown causes), though the following might be factors:

  • Trauma
  • Surgery (especially shoulder surgery)
  • Inflammatory disease
  • Diabetes
  • Shoulder immobilization

CONVENTIONAL TREATMENT:

  • Conservative treatment can include the following:
  • Heat and physical therapy to stretch and increase range of motion
  • Anti-inflammatory medications (NSAIDs)
  • An oral corticosteroid such as prednisone
  • Injections of cortisone directly into the joint

 

Frozen shoulder can be very painful and resistant to these treatments, and can persist for years. So if the usual range of treatments is ineffective, more aggressive intervention might be suggested such as:

  • Manipulation under anesthesia. During this procedure, you are put to sleep. Your doctor will force your shoulder to move which causes the capsule and scar tissue to stretch or tear. This releases the tightening and increases range of motion.
  • Arthrographic distension. Similar to the above, but a small amount of contrast material is injected into the joint and then watched through radiological imaging.
  • Shoulder arthroscopy. In this procedure, your doctor will cut through tight portions of the joint capsule.
  • Subacromial decompression. The operative theory is that the pain is caused by impingement of the tendons (pinching) of the shoulder due to lack of space. The solution is to cut off the end of the scapula (acromion) or smooth the supposedly roughened socket bone, thus opening more space for the tendons to move freely.

Unfortunately, many of the above treatments can have harmful side effects.

  • NSAIDs can cause nausea and vomiting, and can affect digestion and cause ulcers. They can also affect the kidneys and cause retention of fluid.
  • Oral steroids such as Prednisone can also cause loss of sleep, vomiting, and mood changes among others.
  • Steroid injections may cause permanent softening and damage of tendons, ligaments and tissues along with other side effects.
  • Forced manipulation can further damage the structures of the shoulder such as the rotator cuff and generate increased pain.
  • Recovery from surgery, if successful, is often slow and painful. Success is a relative term, however, and these “successful” surgeries rarely if ever restore the joint to 100% painless function.

DMR Therapy® point of view and treatment:

Trigger points are rarely considered but often are a major factor in the development of frozen shoulder. If not recognized promptly, the inflammatory reaction of tendinitis caused by trigger points in the muscle can cause fibrosis of bursa, which leads to adhesive capsulitis.

The most common cause of shoulder restriction is the subscapularis muscle, which attaches to the inside of the scapula. Symptoms of frozen shoulder are identical to those of trigger points in this muscle which is often overlooked as a cause of shoulder restriction and pain. If treated promptly, release of this muscle often releases the shoulder. However, by the time the shoulder becomes frozen (a prolonged process), many other shoulder girdle muscles have become involved. The supraspinatus, antagonist of subscapularis, for example, is one of the first to be affected.

If the trigger points of one muscle are released but those of the antagonist are not, the imbalance will cause the muscle to tighten again.

Frozen shoulder can be challenging because by the time the shoulder becomes immobile and the pain extreme, many if not all of the muscles of the shoulder need to be addressed. The fascia or connective tissue is a major factor. It can become thick and tough and painful as a result of the high number of pain sensors. However, DMR Therapy®, with ample experience in treating shoulder issues, specializes in releasing the involved tissues manually rather than tearing or cutting them. With this method, shoulder issues can be resolved rapidly with none of the usual side effects.

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