I The incidence of frozen shoulder in the general population is approximately 2%.(an increased incidence associated with, including diabetes mellitus(up to 5 times more), cervical disc disease, hyperthyroidism, intrathoracic disorders, and trauma. People between the ages of 40 and 70 are more commonly affected. Common to almost all patients is a period of immobility, the etiologies of which are diverse
◼ The incidence of frozen shoulder in the general population is approximately 2%. (an increased incidence associated with, including diabetes mellitus (up to 5 times more), cervical disc disease, hyperthyroidism, intrathoracic disorders, and trauma). People between the ages of 40 and 70 are more commonly affected. Common to almost all patients is a period of immobility, the etiologies of which are diverse
Primary frozen shoulder a Primary frozen shoulder is a vague entity that only rarely recurs in the same shoulder. The clinical course of primary (idiopathic) frozen shoulder consists of three phases Phase i--Pain. Patients usually have a gradual onset of diffuse shoulder pain, which is progressive over weeks to months The pain usually is worse at night and is exacerbated by lying on the affected side. As the patient uses the arm less, pain leading to stiffness ensues
Primary Frozen Shoulder ◼ Primary frozen shoulder is a vague entity that only rarely recurs in the same shoulder. The clinical course of primary (idiopathic) frozen shoulder consists of three phases. ◼ Phase I—Pain. Patients usually have a gradual onset of diffuse shoulder pain, which is progressive over weeks to months. The pain usually is worse at night and is exacerbated by lying on the affected side. As the patient uses the arm less, pain leading to stiffness ensues
Primary frozen shoulder Phase ii--Stiffness Patients seek pain relief by restricting movement. This heralds the beginning of the stiffness phase, which usually lasts 4 to 12 months. Patients describe difficult With activities of daily living: men have trouble getting to their wallets and women with astening brassieres. As stiffness progresses, a dull ache is present nearly all the time( especially at night), and this often is accompanied by sharp pain during range of motion at or near the new endpoints of motion
Primary Frozen Shoulder ◼ Phase II—Stiffness. Patients seek pain relief by restricting movement. This heralds the beginning of the stiffness phase, which usually lasts 4 to 12 months. Patients describe difficulty with activities of daily living; men have trouble getting to their wallets and women with fastening brassieres. As stiffness progresses, a dull ache is present nearly all the time (especially at night), and this often is accompanied by sharp pain during range of motion at or near the new endpoints of motion
Primary frozen shoulder a Phase ill--Thawing. This phase lasts for weeks or months, and as motion ncreases, pain diminishes. Without treatment(other than benign neglect) motion return is gradual in most but may never objectively return to normals although most patients subjectively feel near normal, perhaps as a result of compensation or adjustment in ways of performing activities of daily living
Primary Frozen Shoulder ◼ Phase III—Thawing. This phase lasts for weeks or months, and as motion increases, pain diminishes. Without treatment (other than benign neglect) motion return is gradual in most but may never objectively return to normal, although most patients subjectively feel near normal, perhaps as a result of compensation or adjustment in ways of performing activities of daily living
Secondary frozen shoulder Unlike patients with idiopathic frozen shoulder patients with secondary frozen shoulder can recall a specific precipitating event, possibly related to overuse or injury. The three phases of classic frozen shoulder may not all be present and may not follow the previously outlined chronology; fortunately, treatment for the two entities is similar
Secondary Frozen Shoulder ◼ Unlike patients with idiopathic frozen shoulder, patients with secondary frozen shoulder can recall a specific precipitating event, possibly related to overuse or injury. The three phases of classic frozen shoulder may not all be present and may not follow the previously outlined chronology; fortunately, treatment for the two entities is similar