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Frozen shoulder or adhesive capsulitis, a tale of two shoulders

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#1
Scratch

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I write this in hope that it may provide benefit to those who will some time experience the onset of shoulder pain with no apparent injury that caused its development.

My first frozen shoulder occurred in the right one beginning in 2003. At that time, I was a lazy diabetic, I took 2 shots of NPH daily, tested very infrequently, and used R insulin on a sliding scale for corrections. I didn't like going to the doctor and still don't, but doctors are a necessary source for all of us if we want to get the best out of treatment options available.

The frozen shoulder in the right grew progressively worse through the first half of 2004. I was constantly in pain, couldn't reach my back pocket with my right hand, couldn't raise my arm up above shoulder level. Finally, the inflammation eased and began to subside over the second half of 2004 and the shoulder began thawing out in 2005.

Basically, it was untreated frozen shoulder that took around 18 months to develop, go through the worst and then finally resolve.

Having since improved how I handle being diabetic, one of my biggest hopes was that better control and treatment would prevent me developing adhesive capsulitis in my left shoulder. Also over the last few years, I've become quite active. I do a lot of various types of strength training, and take it seriously as a way of being healthy both physically and emotionally.

But in February of this year, I began noticing twinges with the shoulder. If I did an overhead press, the left shoulder would tweak while I lowered the weight down from overhead. If I was driving and I had my left hand up on the top of the wheel for a prolonged time, the shoulder would ache. I went through the bit of denial period, that it would get better on its own, but it didn't. It grew more insistent.

At the end of March, I went to my doctor and described what was going on. He checked out my range of motion, prescribed physical therapy for me along with meloxicam, an anti-inflammatory. I went to PT where the therapist evaluated my range of motion which had already become restricted some. He showed me a set of stretches to do, stretches I would do each session I went to, and very importantly, stretches I would do on my own time nearly every day. Also at the therapy sessions, he would manipulate my shoulder and arm through the range of motion that we wanted to achieve.

I'm happy to say that last week I went to my last PT session. Over the past 2 weeks, it has become apparent that the inflammation in the shoulder joint is going away. Back in April, if I forgot to take the meloxicam, my shoulder would ache badly. At the end of May, I had a day where I forgot to take it, there was no great pain and I've been able to stop taking it.

This brush with frozen shoulder looks like it will be all done with in about 4 months of time. That's a huge difference from the 18 months of the prior one.

I feel the following were key to this --

1. early intervention. I caught this early and sought treatment.

2. anti-inflammatory medication. Adhesive capsulities is an inflammation where the body builds too much fibrin and collagen into the joint. An anti-inflammatory can help reduce that.

3. staying active. I kept using the shoulder, even when it twinged some. When my right shoulder went bad, I babied it and avoided using it. I kept using my left shoulder as much as possible this time. I think that doing so helps to break up the gunk that wants to build up in the joint.

Other things that I believe helped or may help --

1. vitamin D. This is getting a lot more attention now and there's good reason. I highly recommend supplementing it into your diet. So far as is known, every cell in the human body has vitamin D receptors necessary to functions the cells can do.

2. Fish oil. This goes to the idea of reducing inflammation. The science about the anti-inflammatory benefits of omega-3 fatty acids is very strong.
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#2
foxl

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I had it about 8 weeks post-diagnosis.

I treated it myself with ibuprofen, heat, and PROMs (progressive range of motion exercises). Obviously mine was quite mild, lasting on the order of several weeks, not months. It still absolutely sucked. To the point where I have not done upper body work since.

I still worry about doing upper body work.
Linda


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#3
Jan B

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Very good information Scratch. I spent over seven years with my frozen shoulders. I tried everything, but looking back, wasn't as persistant as I should have been with the exercises and therapy. I seriously never seemed to get better, and quit doing the stretches as much as I should have. Time seemed to be the only healer. My second shoulder began hurting as my first one was finally to the point of thawing. It "only" lasted a little over 2 years. I was also keeping the diabetes in better control as time went on. I believe even more that nasty things are much more likely to happen if we let our control slip.

Thank you so much for speaking of Fish Oil again. I need it. I can no longer take anti-inflammatories because of my stomach. Half of it was just about ulcerated, and had started bleeding, because of long-term use of NSAIDS (frozen shoulders, arthritis, and other chronic pain). To go from pain relief from anti-inflammatories, to a bleeding stomach was a shock. We don't seem to get enough warning about nsaids anymore. And as diabetics, we tend to have more inflammation.

Vitamin D? I'm on it :)
Jan

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Diagnosed at age 18

#4
GretchO

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I developed adhesions in both shoulders almost simultaneously at a period in my diabetes care when I was completely and totally off the wagon as far as control went. Took my insulin religiously but never ever tested. When I finally went back to my endo, my A1C had skyrocked to a 10.something from what had always been in the mid 5s. I had had the adhesions for at least 6-8 months before I finally went to see my endo.

I ended up doing PT for about a year which was a tremendous help in easing the pain and getting some range of motion back, in addition to the stretching exercises I was given for home. I had lost about 70% of my range of motion in both arms. I was never given an anti-inflammatory meds but did have two series of cortisone injections into the capsules of both shoulders. The cortisone didn't do anything for my range of motion, but did help ease the pain a bit. Fortunately for me, the cortisone stayed in the capsules and I never had a problem w/ my blood sugars from the injections. (And aye carumba are those needles big...)

Oddly enough, the thing that loosened them up the most was pregnancy - i think (and this is totally my own theory) the hormones that are released to prepare your hips for birth did a number on what remained of the adhesions.

Haven't had any flare ups since then, thankfully. But Snatch is completely right in his conclusions of early intervention/treatment and staying active. Doing the stretching exercises always made me feel better afterwards. Once I found out that using them wasn't doing damage I tried to use them as much as I could. I do lots of upper body work - 45 push ups twice a day, currently working my way up. Anything that stretches them (butterflies at the gym) makes them feel really good afterwards.
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#5
juan_perez

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I had it, and I inmediatly started physical therapy, and used naproxen and paracetamol. I also used a local anti-inflammatory.

It was a torturing pain. But, fortunately, it lasted just a month. So, I think that confirms that FS can go away if you catch it early. Anyway, it was **** to live with it.

My advice: if you are recently diagnosed with FS, do physical therapy as soon as posible, and use anti-inflammatory drugs. Maybe you can stop it quickly.

Have a nice day!!!
Diagnosed 15 sep 09 A1c 11.5
Dec 09 A1c 6.5 (with insulin and metformin)
Feb 10 A1c 7.5 (after quitting all meds)
Apr 10 A1c 6.2 (diet and exercise)
May 10 A1c 5.2 (diet and exercise)
Dec 10 A1c 5.8 (diet and exercise)
Dec 13 A1c 6.2 (diet and exercise)

#6
notme

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I had it the first time in about 1998 it lasted over a year with early intervention and anti-inflammatory. I got it again about three years later in the other shoulder. I immediately started PT and anti-inflammatory. It was bad, but not as bad as the first time. The first time was torture. The second time it lasted for one year. Cortisone shot did help, but didn't fix it completely. I was able to kayak and use my shoulder with that movement both times. I stayed active, but it was painful.

Honestly, I hope it never comes back. My control back in the early 2000's was good. I wish I had the answers.

I am taking vitamin D now. I sure hope your right and it helps.
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#7
momof3

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Thank you so much Scratch! I just happened upon your post by searching for Frozen Shoulder......just started PT for my second shoulder. Saw a new therapist today and was a "VERY" painful session when he was pushing so hard! But, I guess that is what I need. Unfortunately, the PT can get pretty pricey and with insurance (for my plan). I am tired of being in pain and not being able to sleep well. I work in the medical field and have been off work the last 2 weeks due to the pain and lack of good sleep. My first shoulder has not even thawed yet, but it not nearly as painful.

Just glad to get advice and hear that I am not the wimp I am sure everyone thinks I am!
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adding Glimeperide 2mg/daily
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#8
Scratch

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Thank you so much Scratch! I just happened upon your post by searching for Frozen Shoulder......just started PT for my second shoulder. Saw a new therapist today and was a "VERY" painful session when he was pushing so hard! But, I guess that is what I need. Unfortunately, the PT can get pretty pricey and with insurance (for my plan). I am tired of being in pain and not being able to sleep well. I work in the medical field and have been off work the last 2 weeks due to the pain and lack of good sleep. My first shoulder has not even thawed yet, but it not nearly as painful.

Just glad to get advice and hear that I am not the wimp I am sure everyone thinks I am!


Yeah, to get the most out of the therapy, you got to grit your teeth some while the therapist works on improving the range of motion. You can do a lot with the stretches, but the therapist can position themselves to push with a good advantage and also to a point where it's a bit more painful than a person can accomplish on their own.

The frozen shoulder I had in my right one was some of the worst pain I've ever experienced. Chronically, it was always there at some dull level. Times when I jarred the shoulder resulted in pain that was a 10 on the 1 to 10 scale, pain as bad as the time my a molar abscessed and the dentist went and tapped on that molar.

I hope you get a fairly quick resolution of it.
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#9
Scratch

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I need to update this, in case it turns up for people in Google searches and they think that what I said in the opening post is the whole story.

While I am glad that the PT had me back to almost full range of motion in June of last year, the underlying problem of the shoulder capsule being inflamed, and becoming more inflamed as time passed, had not gone away. I continued to try to keep using my left arm fully, do the stretches and mobility exercises, but as time passed the pain got worse and range of motion decreased. I think the pain peaked during December.

The initial painful stage has now passed. I have a lost a fairly large range of motion, although not as bad as my prior experience in the right arm. To the front, I am able to elevate my arm above shoulder level, to the side, I can raise my arm to shoulder level, I am able to reach into my back pocket with a bit of discomfort. This is a bit of improvement from the worst point a couple of months ago.

So I believe now I'm moving into the stage where I will begin to see a gradual improvement in range of motion, that the underlying inflammation has subsided and now it's a matter of the junk that's collected in the shoulder capsule to disappear.

Anyhow, frozen shoulder sucks. It truly does. Anyone who has not been through will not understand what a person means about the pain being the worst they've ever experienced. It can truly result in moments of where the perceived pain scale of 1 to 10 doesn't work, the pain goes beyond what many people would regard as 10.
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#10
notme

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I need to update this, in case it turns up for people in Google searches and they think that what I said in the opening post is the whole story.

While I am glad that the PT had me back to almost full range of motion in June of last year, the underlying problem of the shoulder capsule being inflamed, and becoming more inflamed as time passed, had not gone away. I continued to try to keep using my left arm fully, do the stretches and mobility exercises, but as time passed the pain got worse and range of motion decreased. I think the pain peaked during December.

The initial painful stage has now passed. I have a lost a fairly large range of motion, although not as bad as my prior experience in the right arm. To the front, I am able to elevate my arm above shoulder level, to the side, I can raise my arm to shoulder level, I am able to reach into my back pocket with a bit of discomfort. This is a bit of improvement from the worst point a couple of months ago.

So I believe now I'm moving into the stage where I will begin to see a gradual improvement in range of motion, that the underlying inflammation has subsided and now it's a matter of the junk that's collected in the shoulder capsule to disappear.

Anyhow, frozen shoulder sucks. It truly does. Anyone who has not been through will not understand what a person means about the pain being the worst they've ever experienced. It can truly result in moments of where the perceived pain scale of 1 to 10 doesn't work, the pain goes beyond what many people would regard as 10.


You are so right Scratch. I live in fear of ever getting frozen shoulder again. I have also had it in both shoulders and both times it took over a year to resolve. I had early intervention the second time and it really did no good. Cortisone helped the final phase the second time, but honestly, I did cortisone early on the first time and it gave me a day of peace and then went right back to hurting beyond belief. Doctors sort of shrug about it because they know it will resolve eventually. However, the patient goes through a year or more of torture waiting. They need to find an answer to this very debilitating problem.
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Nancy


“I don't expect everything to be handed to me. Just set it down anywhere.”.




diagnosed type 1 October 1986
currently using Medtronic MiniMed
Revel 723 with CGMS
CLEAR [SIGPIC][/SIGPIC]

#11
Scratch

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You are so right Scratch. I live in fear of ever getting frozen shoulder again.


I know what you mean about the fear of recurrence. The sources I've found state that to have recurrence in the same shoulder is extremely rare, but it's not impossible. But both you and I know that the fear is because we know what it's like. The increasing pain stage where eventually you can't sleep comfortably anymore, where any situation that your arm gets jerked or jolted results in horrible pain, the loss of ROM, where you find yourself unable to do things in typical fashion, things like putting on clothes, washing your hair, reaching to pick something up, etc. And the fact that at a minimum, it's going to last at least a year, but it usually takes people 2 years before the ROM is back to normal or near normal.

Yeah, I'm probably going to be a bit paranoid about it for the rest of my life.
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#12
Mich

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Hi Scratch (and Nancy)
I'm glad to hear you are both out of the frozen shoulders. I've had it twice also, once in each shoulder. First time I was clusless and went through several years of inept PT and drugs.

The second time, I took matters into my own hands and did my own program (which is exactly like Scratch's step 1-4 program) with determination--I sure DID NOT want another frozen shoulder! I used the stretches they taught me the first time. My favoritye is hopping into a hot shower, walking my fingers up the wall a few times while the hot water is on my shoulder, then stretching it every way possible. I took ibuprofen as an anti inflammatory.

Frozen shoulders are efinitely someting to avoid at all costs, and hopefully without medical intervention.

Mich

#13
Harold

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This strikes home. Had the right shoulder before diabetes try to freeze up with a lot of constant pain. My doc sent me to an orthopedic and he wanted to operate on my wrist. Never went back to him. Kept moving it and taking ibuprofen for the constant pain. This was 15 years ago and I read about a doctor in Colorado doing sports injuries that used deep shoulder message to relieve and to keep shoulders from freezing. Last fall hurt my left shoulder while in bed sleeping trying to get to an itch. Now I can not use my left arm to truck my shirt in. So I am moving it as much as I can stand and doing the deep massage. The Ibuprofen I am trying to stay away from since I started bruising easily on my arms.

#14
Scratch

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Last fall hurt my left shoulder while in bed sleeping trying to get to an itch. Now I can not use my left arm to truck my shirt in. So I am moving it as much as I can stand and doing the deep massage. The Ibuprofen I am trying to stay away from since I started bruising easily on my arms.


You know what I think? I think you didn't hurt your shoulder while getting to that itch, you just reached with arm in such a way that the shoulder capsule which was beginning to inflame got knocked against and you got that first jolt of pain that comes with frozen shoulder. Anyone who has gone through a frozen shoulder knows about that -- the sudden jolts of pain when you try to reach for something, or jerk your arm in reaction to something.

You see that a lot with a person who gets frozen shoulder. They'll talk about the time they think they initially hurt the shoulder while reaching for something, or when they jerked their arm away from something. But no injury took place with that, it was just the first symptom of the shoulder capsule inflammation which had already begun.
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#15
Harold

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Could be. The injury that caused my right frozen shoulder happened a few years before the shoulder froze up.

#16
RJC

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I got frozen shoulder last year - 2013 - in my right shoulder. Had never heard of frozen shoulder - until my doc told me about it. Did everything - tons of physical therapy, cortisone shot, diet changes, diabetes control, various exercises - but it got worse. The MRI showed what looked like a torn rotator cuff - and a torn bicep. My ortho surgeon suggested surgery, which I agreed to. Man, what an ordeal. He got in there and found that the rotator cuff was not torn at all - but the frozen shoulder was the worst he had ever seen. He ended up cleaning it out, and stapling my bicep to the bone. It's been six weeks since the surgery and I have no better movement than pre-surgery, and the pain is unbearable at the moment. I know it will get better - but it has been quite the ordeal. My left shoulder is now experiencing frozen shoulder. I believe that my right shoulder started, obviously, with the torn bicep....thus, really complicating matters. Honestly, I don't know what else I can do for the right one at this point except to continue PT, stretching, eating right and controlling diabetes(Type I for 42 years) and so forth. The left....I'm doing daily stretches now, but to no avail. Just going to have to run its course. Have decided not to do the surgery on it though......surgery was pretty gnarly experience for me.






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