Painful winter!

Winter could not be a season of enjoyment for the patient who got musculoskeletal pain. Cold weather might exacerbate neck, back, knee or elbow pain.

Among the all physical pain, shoulder pain is egregious. This condition not only makes the patient's life hell, but also steals their sleep. Patient might feel thunder bold spark when s/he turns to the affected side and suddenly awakes from deep sleep. It would not be possible to stop that pain by using pain killer or other modalities like heat or cold at midnight.

What are the causes of frozen shoulder?

No doubt, in most cases, frozen shoulder is a disease of diabetic patients. It could be a complication of diabetes mellitus. Most of the time, this condition start with amiable character and mild to moderate pain without any significant threat and seems it might resolve naturally. But it progress with time and gradually limit patient's activity of daily living (ADL).

After 3-4 months of its start, the condition reaches its highest point. Patients cannot take their affected hand to back, could not be able to wear clothes or even feel pain during toilet.

However, this condition might catch the patient without diabetes. It also could be a major complication of cervical spondylosis, shoulder dislocation or other untreated shoulder injury. In all case, indeed, pain would start mildly and progress slow but steadily.

What would be the treatment?

In most of the cases, non-steroidal anti-inflammatory drugs (NSAIDs) are ineffective. Surgery is not recommended here. But integrated pain management (IPM) is very effective here.

IPM includes proper diagnosis. There are number of muscles in shoulder girdle. A specialist must diagnose the exact muscle which is tight and posing threat to the movement. Dry needling could release trigger fascia. Electrotherapy has great effect in pain relief but doctor should choose appropriate one for different cases.

Additionally, manipulation and therapeutic exercise can mitigate pain and increase shoulder movement. It might take several weeks or even months to eradicate pain and get full swing of shoulder joint movement. Intra-articular infiltration might be very helpful in the case of non-diabetic patients. But in the case of diabetic patient, doctor should take care before infiltration of the joint. Sometimes infiltration is ineffective in frozen shoulder caused by diabetes.

Advice:

Diabetic patients should be very careful about any type of shoulder pain and injury. You might get shoulder injury while travelling or doing household works. If you feel pain even after 7 days of your mild injury, consult a specialist and offer him a chance to diagnose your condition. Immediate start of IPM could save your treatment time, sufferings and cost.

The writer is a physiotherapist. E-mail: hprc2005@live.com