Tackling frozen Shoulder

By Lee Sung-hun

Shoulder pain is a rather common type of joint ache. Usually, you notice that one arm is hard to move, to lift the arm is painful and the shoulder aches so much so that at night it becomes difficult to fall asleep.

There are a number of possible underlying causes, and one of the most likely culprits is adhesive capsulitis, commonly known as frozen shoulder.

Frozen shoulder is a condition that brings about pain and limited movement in the joint.

Korean name for adhesive capsulitis translates to “50-year-old-shoulders,” as it used to be most common among people in their 50s. However, nowadays, people in their late 30s or in their 60s and 70s suffer from it.

Patients generally seek medical assistance once they feel the sharp shoulder pain or when the limited shoulder movements make it difficult to conduct ordinary daily activities such as putting on a shirt, or shampooing, or even taking a wallet out of the back pocket.

Such limited motion is caused by the contraction or adhesion of the articular capsule of the shoulder joint or the tendons in the surrounding muscles.

Generally, adhesive capsulitis occurs without any known causes such as external trauma. Various factors can lead to it such as stress that causes tension in the in the shoulder and rotator cuff, wrong posture such as straight neck, and lack of exercise.

Other known contributing factors include sustained fixed posture after an operation, old age and even diabetes. Oriental medicine views such causes to occur from blood stasis, dampness and cold.

Most notably, blood stasis can directly contribute to the conditions, as accumulated blood stasis means that it becomes hard in the surrounding joint and muscles.

Generally, adhesive capsulitis occurs in three stages – painful, frozen and then thawing– but not always in that order. The painful stage refers to the initial three months or so after the first symptom during which severe shoulder pain continues and patients complain of acute pain when they try to move the arm quickly.

Many patients tend to keep the shoulder joint in a fixed position in order to avoid pain-causing posture, but it actually hardens the joint even further as the extent of the motion is limited.

During the frozen stage, referring to the 9 months or so following the painful stage, the shoulder pain itself seems less than the previous stage but the motion of the shoulder joint becomes more limited where a patient feels it difficult to touch the back of the neck, brush hair, or even zip up on the back of a dress for female patients.

The thawing stage refers to the phase where the pain becomes lighter and patient starts to recover the motion in their joint. This stage can last anywhere from several months to several years.

A frozen shoulder is generally a self limiting disease that will resolve on its own within a year or two. However, there are some patients who suffer from continued acute pain, or limited scapular and humeral movement that prevents them from lifting or swinging their arms so much so that they turn their upper torso to achieve the similar effects.

Oriental treatments for adhesive capsulitis include prescription, acupuncture therapy (including moxibustion, cupping, pharmacopuncture, and bee venom) and Chuna chiropractic.

Acupuncture, moxibustion and cupping promote the circulation in the meridian systems to induce recovery. Pharmacopuncture is the direct injection of the effective ingredients from Oriental medicine in the tightened area, and bee venom therapy uses the anti-inflammatory characteristics of the venom to treat the inflammation.

Oriental medicine is prescribed according to the body constitution and the symptoms of the patient to release the tension in the muscle while promoting the circulation of qi and blood.

One of the key factors in the treatment of adhesive capsulitis is the patient’s willingness to exercise the affected arm. The exercise, known as passive stretching exercises, helps in recovering the range of motion of the joint.

Clinically speaking, patients who rely on medical help alone show much slower recovery compared to those who regularly partake in such exercises at home.

There are a number of stretching exercises patients can do to help themselves.

Arm overhead is one where you lift the affected arm up overhead by pulling the wrist with the unaffected arm while lying on your back. Twisting outwards can be performed sitting down or lying on the back.

Such exercises should be repeated 10 times for each set to gradually increase the range of motion.

The writer practices Korean oriental medicine

at the UN Oriental Medical Clinic in

Hannam-dong, Seoul.