Frozen Shoulder Got You Stuck? Let's Get Your Arm Back!
Frozen shoulder AKA "Adhesive Capsulitis" is awful. You can't move it, do stuff with it, and even sleeping is difficult. Sound like you? Maybe someone you know? Here is a breakdown of the effective treatment approach our physios use - featuring our very own low intensity laser - at Avalon Laser Health!
In physio circles, a recent conference highlighted some important new information about the treatment of frozen shoulder.
So what's going on in that shoulder of yours?
Adhesive Capsulitis is an uncontrolled and exaggerated inflammatory response associated with an equally uncontrolled and exaggerated healing response. This results in an excessive amount of scar tissue over the capsule of the shoulder joint. These completely over-reactive, out of control protection and healing mechanisms are caused by hormonal imbalance, and sometimes there is even an association with heart disease and/or neck conditions. Altogether, frozen shoulder is a serious condition, not to be taken lightly.
Some things we know:
Frozen shoulder follows a predictable pattern: You wake up one morning with a 'stiff and painful' shoulder joint, and are unable to pinpoint specific injury. The pain increases quickly over time and your shoulder becomes progressively stiffer. This is the "freezing" phase which lasts between 6 weeks and 9 months. The subsequent "thawing" phase brings a welcome reduction in pain and some improved mobility.
By the time the injury has reached the "thawing" phase, it is clear that the joint will need rehab to restore strength and function. However, we know exercise has not been shown to be helpful during the freezing phase of the development of frozen shoulder.
The pain associated with the freezing phase can be severe, and typical treatment options for pain management, range from anti-inflammatory and pain medication, often in high doseages, to steroid injections, and sometimes to surgical options.
But...there is an accumulating number of high quality of research studies, including one from an acclaimed Cochrane Review, that indicates that low intensity laser is effective in decreasing pain during the freezing phase! For those who don't like to (or can't) ingest large amounts of pain or anti-inflammatory medications, this is excellent news.
To be fair and upfront, there was no duration effect reported in the research, perhaps because the length of time the joint spends in the freezing phase is so variable. Two actual patient case reports presented at the conference required 9 and 21 laser treatments, respectively, to achieve 80% clinical improvement, with a maintenance program of one laser monthly recommended in the latter case. This means every shoulder will take it's own time to heal, however, the known action of low intensity laser serves to accelerate healing.
For the technically inclined, the laser stimulates the healing process by stimulating ATP production (i.e fuel/energy) inside the cell and modulates the levels of superoxide radicals required to reduce cellular stress.
Using this research, our recommended treatment plan in the clinic is two-fold:
- Consult with your medical and/or naturopathic doctor to get your diagnosis first. Secondarily, to identify and manage the underlying root causes for the flare up such as hormonal imbalances, and other possible associated conditions that are reported to exacerbate the "frozen shoulder" condition.
- Start laser therapy as early as possible following diagnosis, supplementing laser with physio/massage (initially very gentle, of course), and waiting for pain to subside at least 50% before exercises for rehabilitation are initiated.