Frozen shoulder is an inflammatory condition of the shoulder which restricts movements.

Thr shoulder joint is a very useful and dynamic joint of human body. It is a �ball and socket� type of joint and offers a wide variety of movements in nearly all directions. The shoulder joint mainly consists of two bones, the Scapula (shoulder wing bone) and the Humerus (arm bone). It also consists of several muscles and strong ligaments which collectively form a strong capsule like structure called �Rotator Cuff� which provides immense strength to this very useful joint. The shoulder joint also allows passage of some important blood vessels like Brachial artery, which is used to assess the blood pressure. It also provides way to very important nerves like Median, Ulnar and Radial nerves. It also contains important lymph nodes called Axillary lymph nodes.

Frozen shoulder can affect persons of all ages, but it usually appears after the age of 40 years. This is due to the age related changes which result in weakness of shoulder capsule making it more prone to injuries.

Physical examination is the prime test to diagnose Frozen shoulder. The doctor asks the patient to carry out wide range of movements which elicit characteristic signs and lead to diagnosis. Following tests can be done to confirm the presence of Frozen shoulder and to assess its severity:

-Complete blood count.
-ESR (erythrocyte sedimentation rate).
-C-reactive protein.
-Blood sugar.
-Thyroid hormone assays.
-Plain x-ray of shoulder joint.
-Arthrography (x-ray of shoulder joint using contrast dye).
-MRI of shoulder joint.
-Arthroscopy (endoscopy of the shoulder joint).

The mainstay of treatment of Frozen shoulder is the combination of medical treatment and physical therapy. Surgery can also provide added effects or can react as the last resort. The treatment modalities are explained as under:

Medical treatment:

-Medical treatment can be initiated by the use of NSAID’s (non-steroidal anti-inflammatory drugs). The use of NSAID’s provides initial pain relief which is very much necessary to facilitate the physical therapy later which is difficult to carry out with the underlying pain.

-For patients with severe stiffness and movement restrictions, steroids can be administered in the form of injection.

Physiotherapy:

-Physiotherapy can be provided along with medical therapy which aids in release of the stiff joint.

-Different exercises some of which are performed by the patient himself under the supervision of a skilled physiotherapist are all aimed towards providing early mobilization and rehabilitation.

Surgical intervention:

-If above measures fail or if the disease is more severe, then surgical manipulation of the joint is an option.

-The aim of surgery is to make room in the capsule for the shoulder joint to move freely. It involves removal of scarred tissues and ligaments.