Horizon Prime Hospital - Thane

Hyperbaric Oxygen Therapy Is An Add-On Effective Treatment For Chronic Pain
Ouch! My shoulder is hurting, unable to lift my hand to take my shower also. Someone who is experiencing shoulder pain can face difficulty in doing simple tasks like taking a bath, dressing, carrying a bag or luggage and many more such basic activities. A frozen shoulder takes around two to nine months to develop and people between the age of 40-60 tend to experience frozen shoulder more than others.

Frozen shoulder, or adhesive capsulitis, presents a challenging condition that significantly impacts one’s range of arm motion and overall comfort. Frozen shoulder is a painful and restrictive condition that primarily affects the shoulder joint and it is characterised by stiffness, pain and a significant reduction in the range of motion of the affected shoulder. This condition can have a profound impact on a person’s quality of life, making even simple everyday activities a challenge. The condition typically impacts individuals between the ages of 40 and 60, with a higher prevalence among women compared to men. Notably, those with diabetes face an elevated risk of developing a frozen shoulder.

The bones, ligaments and the tendons of the shoulder joint are encased in a capsule of soft tissue. When this capsule becomes thick it restricts the movement of the shoulder joint. This normally happens when the shoulder joint is not used for some time due to some kind of surgery like fracture of the arm or mastectomy. People with some conditions like diabetes are also more likely to suffer frozen shoulder. Women are more prone to this condition than men. Frozen shoulder typically develops slowly and can last up to 3 years.

Dr Hrushikesh Vaidya, Medical Director and Chairman, Horizon Group of Hospitals said “Frozen Shoulder is extremely painful and the one who has experienced it will understand the pain that they have undergone. Experiencing a frozen shoulder during winter can be extremely painful. Every year, 3 out of 10 people suffer from frozen shoulders during winter. It is a disorder that causes pain, stiffness and loss of normal range of motion in the shoulder. Have you ever noticed that during winter, you suddenly feel pain all over your body? Well, cold temperatures tend to bring a unique set of painful challenges, especially around the shoulders. One of the most common types of disorder is frozen shoulder, also known as adhesive capsulitis. Thus, make sure that you consult a doctor in the early stage as it will safeguard your shoulder’s health and you can enjoy the winter season without the added discomfort of a frozen shoulder.”

Dr Hrushikesh Vaidya further said “At our Horizon Group of Hospitals, we have introduced Hyperbaric Oxygen Therapy (HBOT) that offers a new and extremely exciting way to help reduce chronic pain. Chronic pain affects sleep, stamina, appetite, and mood, and can lead to reduced flexibility and strength. With good reason, chronic pain can create feelings of anxiety, uncertainty, and sadness. Hyperbaric oxygen therapy is a non-invasive treatment that uses pressurized oxygen to decrease inflammation and accelerate healing. Chronic pain sufferers report less pain and swelling, and more freedom from pain medications following hyperbaric oxygen therapy regimens. Hyperbaric oxygen therapy is an effective treatment for many of the symptoms of chronic pain like inflammation, fatigue, limited mobility, and nerve pain. HBOT provides relief for chronic pain. It not only accelerates healing, but often creates better results. HBOT is well known for its ability to increase oxygenation in our body and brain, expediting healing. Another extremely beneficial effect of HBOT is its ability to stimulate growth hormones, such as fibroblasts and collagen factors that improve ligament, tendon, and joint flexibility and strength. Frozen shoulder patients can take benefit of this excellent add-on therapy module for early recovery. If you’re about to go through surgery, considering Hyperbaric Oxygen Therapy may be the difference maker in your success!”.

Dr Ria Vaidya, CEO, Horizon Group of Hospitals said “One never even think about shoulders as to how important part it’s of our body for taking bath, wearing clothes and every time to lift your hand up to even call God. One doesn’t realise about this body part, until when suddenly one starts experiencing pain in one of them. Shoulder pain can make a simple act — brushing and drying your hair, reaching behind your back to fasten a bra, or grabbing something overhead — seem like a monumental task. As you age, you’re more likely to experience shoulder pain from a variety of common conditions. The pain can come on gradually or abruptly, and it may range from mild to excruciating. If you do experience shoulder pain, it’s not always possible to figure out the cause. Sometimes problems in other parts of the body are actually the source of the pain, which then radiates to your shoulder. This can happen with certain neck problems, including arthritis and disc herniations. In general, if you are experiencing a lot of pain or know you injured yourself, it’s best to see a doctor right away to have your shoulder condition diagnosed.”

Dr Parth Agarwal, Leading Arthroscopic Surgeon and Sports Injury Expert and Consultant, Horizon Prime Hospital said “Frozen shoulder is medically known as adhesive capsulitis. It is a common cause of shoulder pain and loss of motion in those who are in their 40’s or older. The condition may be caused by issues related to thyroid toxicity or immunodeficiencies, such as rheumatoid arthritis, SLE arthritis and diabetes. Injuries may also play a part, especially in sports that require extensive use of the muscles in the arms and shoulders, like tennis and golf. Unfortunately, it can result in a considerable disruption to any sports activity, especially given how long it usually takes to resolve. The treatment options for frozen shoulder are medications, physical therapy and in some cases Arthroscopic Surgery. The objective of the treatment is to control the pain and to preserve the range of motion of the shoulder. Painkillers and anti-inflammatory medications are used for some days to achieve this goal. Recovery from a frozen shoulder is a gradual process that takes several months to a few years.”

Dr Parth Agarwal suggests below few tips that can prevent shoulder pain issues.

• Maintaining proper posture helps ease shoulder pain.
• Repetitive overhead movements should be avoided as they may lead to shoulder impingement.
• To keep your shoulders strong and flexible, do frequent workouts.
• Make sure you lift objects properly to prevent putting too much strain on your shoulders.

Three Stages Of Frozen Shoulder
Frozen shoulder progresses through distinct stages, each marked by specific symptoms and challenges. There are 3 stages of frozen shoulder :

• Freezing Stage – In this stage any movement of the shoulder causes pain which reduces the range of movement of the shoulder. During the “freezing” stage, pain gradually intensifies, accompanied by a diminishing range of motion in the shoulder. This stage typically lasts between 6 weeks to 9 months.
• Frozen Stage – Pain is less during this stage but the shoulder is stiff and movement of the shoulder becomes difficult. While pain may somewhat alleviate in the “frozen” stage, stiffness persists, making daily activities challenging. This stage spans approximately 4 to 6 months.
• Thawing Stage – The range of motion in the shoulder becomes better. The “thawing” stage sees a gradual improvement in shoulder motion. Complete recovery or a return to near-normal strength and motion usually takes from 6 months to 2 years.

Causes

• Immobilisation: A frozen shoulder can often occur when the shoulder has been immobilized for an extended period due to injury, surgery, or illness.
• Overuse Injuries: Conditions such as tendinitis or bursitis of the rotator cuff can contribute to inflammation and, subsequently, frozen shoulder.
• Underlying Conditions: Certain medical conditions like thyroid disorders or Diabetes or Parkinson’s disease may increase the risk of developing frozen shoulder.

Symptoms

• Night time intensity: Pain in the shoulder joint is often more intense at night during the initial stages of a frozen shoulder.
• Gradual increase in pain: There is a gradual increase in the severity of pain, contributing to discomfort and reduced shoulder function.
• Pain in movement: Movement of the shoulder is associated with varying degrees of pain, ranging from mild to severe.
• Joint Rigidity: The shoulder joint exhibits rigidity, contributing to the overall limitation of the range of motion.

Diagnosis
To diagnose a frozen shoulder, the doctor will engage in the following steps:

• Evaluation of Symptoms and Medical History
• Physical Examination of Arms and Shoulders
• X-rays
• MRI

Treatment
The treatment for frozen shoulder focuses on two primary objectives: pain relief and restoring normal shoulder function.

• Hot and cold compresses: Applying hot and cold compresses aids in pain and swelling reduction.
• Pain and swelling medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen are common for pain relief. Steroid injections may be prescribed for more severe pain and swelling, involving direct injection into the shoulder joint.
• Physical therapy: Physical therapy is often the cornerstone of treatment, with a focus on stretching exercises to regain flexibility and later on strengthening exercises. Physical therapists guide patients through stretching and range of motion exercises.
• Home exercise program: In addition to professional physical therapy, individuals are encouraged to perform gentle, at-home exercises to maintain and improve their range of motion.
• Transcutaneous Electrical Nerve Stimulation: Using a small, battery-operated device helps alleviate pain by blocking nerve impulses.
• Surgical Intervention: In extreme situations or if conservative therapy are ineffective, surgery may be required to relieve the shoulder pain. In shoulder arthroscopy, the doctor performs a capsular release by cutting through the tight portions of the joint capsule. Small, pencil-sized instruments are inserted through minor incisions around the shoulder. These procedures are often combined for more optimal outcomes. The purpose of surgery is to stabilise the shoulder joint or repair damaged tissues.

The Final Takeaway
Our shoulder is similar to a crane or an earthmover that has a long handle and at the end of the handle there is a hook for lifting things. Even if the hook for lifting might seem important, it’s the long handle that’s providing the strength. Hence, our shoulder is similar to that long handle of a crane. We need to be extremely cautious while lifting heavy weights, or while pushing or pulling things or rotating hands in motions. A shoulder once dislocated can have multiple recurrences, so it is advised to pursue strength and stability exercises that’s recommended by the doctor. Horizon Prime Hospital Sports Injury and Orthopaedics department is a comprehensive centre that is dedicated to the bone, muscle, and joint health. We provide a wide range of care including diagnostic care, medication, physiotherapy, dietary guidance, and preventive care. We aim to assist the patients while easing their symptoms with the help of cutting-edge technology and the most advanced multi-disciplinary treatments and also Hyperbaric Oxygen Therapy. Hyperbaric Oxygen Therapy holds promise as a valuable treatment option for patients with Frozen Shoulders. With diligent adherence to prescribed exercises and treatment plans, most individuals experience significant improvement without the need for surgical intervention. If you encounter difficulties or reach a plateau in your recovery, it’s advisable to consult an orthopaedic sports medicine specialist.