New Technique Can Help Patients with "Frozen Shoulder" Syndrome

By: Diana Barnes-Brown for Shoulder1

A new technique known as a subscapularis nerve block has shown promise for patients suffering from adhesive capsulitis, more commonly known as frozen shoulder syndrome, which is a painful condition involving progressive stiffening and loss of mobility in the shoulder.

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There are three main symptoms of frozen shoulder syndrome: Tightening in the shoulder joint that increases over time. Pain in the shoulder that increases with time. Feeling as though the shoulder is stuck or frozen when attempting to complete activities that require mobility, such as putting on a backpack or reaching for something on a high shelf. These symptoms may also be a sign of an underlying shoulder injury or other problem, such as arthritis or congenital joint damage, and should be assessed by a qualified medical caregiver. Thus, it is important to call your doctor if you notice any of these symptoms. He or she can confirm the diagnosis and suggest the best course of treatment.

While frozen shoulder subsides on its own, usually between six months and three years after it develops, the interim period can be debilitating, with patients suffering intense pain and losing the ability to participate in daily activities of work and play. Commuting to work, pushing a grocery cart, walking a dog, or participating in sports may become impossible as pain and loss of motion increase. Though not permanent, the loss of these abilities can negatively impact patients' physical fitness, emotional health, and overall quality of life – and these effects may outlast the duration of the condition itself.

Frozen shoulder occurs when the capsule around the shoulder joint thickens and tightens around the joint itself. This places increasing pressure on the joint, which causes the characteristic pain and limited motion that are the main symptoms of the condition. Frozen shoulder affects about 2 percent of the general population, but is far more frequent in those with particular risk factors. For example, diabetics are five times more likely to develop frozen shoulder than those without diabetes; women, those with family histories of frozen shoulder, and recent breast surgery and thyroid disease patients have a greater chance of developing the condition.

Previously, treatments for frozen shoulder generally involved controlling pain and fighting to increase mobility, often with the help of anti-inflammatory medications such as ibuprofen (the active ingredient in Advil and Motrin) or naproxen (the active ingredient in Aleve), or with corticosteroid injections. Physical therapy can be helpful for the restoration of motion as well, and often patients are instructed to maintain a home exercise program involving lots of stretching until the condition clears up.

The subscapularis nerve block is so named because it acts to block the nerve connected to the subscapularis muscle. The subscapularis muscle is one of the three main muscles that make up the rotator cuff, the socket of soft tissue that holds the shoulder joint in place. To perform the procedure, a shoulder specialist injects a nerve-blocking agent into the subscapular region and “turns off” the nerves that contribute to the pain of frozen shoulder. The technique is unique because rather than chemically acting to reduce inflammation and pain, it goes straight to one of the main nerves that causes pain in frozen shoulder, effectively blocking the nerve’s ability to send pain signals. Also, the nerve block acts locally – on the shoulder alone – thus helping patients to avoid the collateral effects of pain relief methods, such as stomach and digestive irritation and damage, kidney and liver problems, delayed healing, and bleeding disorders.

While the treatment is relatively new, it seems very promising to caregivers and their patients. Without it, they would be left to deal with the pain of frozen shoulder for up to three years – with only physical therapy and anti-inflammatory medication to help their symptoms.

Last updated: 06-Nov-06