Frozen shoulder

What a frozen shoulder is

Adhesive capsulitis, commonly called frozen shoulder, shows itself as loss of shoulder movement or difficulty with it. It begins with inflammation of the connective tissues around the shoulder joint. Those tissues then grow together with adhesions — abnormal bands of tissue — and the result is persistent pain and restricted movement.

It is seen more often in people with a history of thyroid disease or diabetes, and in middle-aged women.

What is understood about the causes

The underlying cause is still not established. As with many conditions of this kind it may involve an autoimmune response: it commonly follows a period of stress, and appears alongside diabetes, degenerative arthritis, circulatory or heart conditions, and hormonal conditions. It is also not unusual after an injury or surgery, which suggests the immune system being signalled to act against tissue that is already healthy.

The three stages

The condition develops in three stages, each lasting roughly three to four months.

• First — moving the shoulder is painful, and finding a comfortable sleeping position is difficult.
• Second — the pain eases, but movement becomes restricted.
• Third — both the pain and the range of movement improve.

The Ayurveda and Siddha approach

Ayurveda and Siddha call this condition apabahukam and relate it to disturbance of the Vata dosha.

External treatments from the Panchakarma group are used: Abhyanga (herbal oil massage), Swedanam (steam), Nasyam (administered through the nose), Vasti (herbal enema), Elakizhi and Pizhichil. Herbal preparations taken orally — kashayam and arishtams — work to clear the system and settle Vata.

A course runs a minimum of ten days, with herbal preparations continuing for several months afterwards. A diet set by the practitioner accompanies it throughout, and following that diet closely matters as much as the treatments themselves. Yoga or a regular exercise routine helps, as does avoiding stressful situations and keeping steady hours for sleep, meals, work and rest.

Worth knowing: a frozen shoulder resolves on its own in almost every case. But it is painful, it disrupts ordinary daily life, and the sleep it costs can lay the ground for further problems — which is the argument for addressing it early rather than waiting it out.

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