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Frozen shoulder

Frozen shoulder is a clinical syndrome of unknown etiology (unknown cause, no evidence of inflammation). Symptoms include pain and reduced shoulder mobility. Patients often complain of stronger pain at night and must take analgesics in order to sleep.
Joint capsule is twisted, thick, and has fibrous changes. X-rays show reduced bone density due to inactivity. Changes are reversible and in most cases recovery is expected soon.

CLINICAL FEATURES
Patients are usually between 40 and 60 years of age. Often they speak of a harmless past trauma (fall, blow, etc.) after which pain and reduced mobility started to present themselves. While examined, they complain of pain in the area of deltoid muscle vertex.
Recovery is reached spontaneously after a year. Pain is reduced, and mobility enhanced.

TREATMENT
The goal of the treatment is to reduce pain and stop further freezing of the shoulder. In early stages rest is advisable, with gradual stretching exercises, and administration of anti-inflammatory non-steroid analgesics. With extra strong blockage, joint capsule can be arthroscopically relaxed (during general anesthesia).

PHYSICAL THERAPY
The goal of physical therapy is to reduce pain with analgetic procedures, exercises, and patient education.
Physical therapy procedures involve: Interferential therapy, laser, ultrasound, and lately excellent results were produced by a combination of hilt therapy , ultrasound, and stretching exercises. I must advise kryotherapy before stretching, so you can make a larger scope of movement with minimal pain.
Advice is to do 10-15 therapies, and repeat them after a month or two.

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