PERI ARTHRITIS
Also called as Frozen shoulder. Commonly seen in diabetic patients. It is characterised by Pain and stiffness in the shoulder joint and restricts movements of the joint. In early stages the pain worst at night and later the pain present at all times. The shoulder capsule around the joint becomes thicken and tightened and restricted the movements around the joint. This is self limiting disease lasting for 6-9 months.
There are two stages:
1. Painful shoulder: Any condition around the shoulder causes pain and limitation of the movements of the shoulder. There is no contracture of the capsule of the shoulder joint. The patient has limitation of movements which is more due to pain rather than due to intrarticular or capsular contracture.
2. Adhesive capsulitis: capsular adhesions form as a result of inflammation in the capsule and synovium. The shoulder becomes more stiffer and the movements around the shoulder becomes more difficult.
Risk factors:
> Above 40 yrs age group > Women affected more than males
> Diabetes
> Post surgery
> Hormonal imbalances
> Sedentary life style
> Rotator cuff injury
> Stroke
> Cardiovascular disease
> Tuberculosis
> Parkinson’s disease
Treatment:
> For pain Analgesics> Intra-articular injection of hydrocortisone May speed up the recovery to decrease pain and improves shoulder mobility in early stages
> Anti inflammatory drugs
> Joint Distension : Injecting sterile water in to the joint capsule to stretch the tissue and to increase the movements in the joint.
> Shoulder manipulation done by the doctor by giving anaesthesia , you may feel no pain at that time and he will move your joint in all directions to loosen the tightened muscles
> Physiotherapy treatment
Physiotherapy plays an important role in prevention and resolution of this condition
> For pain and to reduce stiffness around the shoulder:
1. Hot fomentation
2. Ultrasound therapy
3. Transcutaneous electrical nerve stimulation
4. Wax therapy
5. Massage techniques
> To increase movements around the shoulder joint:
1. Active assisted exercises
2. Shoulder mobilisation techniques
3. Stretching
4. Active range of motion exercises
> For strengthening shoulder joint and muscles :
1. Resisted Exercises
2. Pendular exercises
3. Wheel exercises
4. Pulley Exercises
5. Squeeze ball exercises for hand and fingers
Note: Please consult your doctor before starting any exercise program.
