TESTIMONIALS
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All About Shoulder Pain
The Frozen Shoulder (Adhesive Capsulitis)
This condition has traditionally been considered a medical enigma! It is considered to be the worst of all shoulder problems and is often the end-point of other problems. It is also, unfortunately a ‘waste can’ diagnosis, often made incorrectly.
Frozen shoulder syndrome is a very painful and debilitating condition of the shoulder characterized by pain and severe stiffness. It is a clinical diagnosis and is only very rarely the result of an underlying disease. Fortunately (and curiously) once cured it (almost) never comes back on the same shoulder. It often comes on for seemingly no reason at all (primary) but may follow a trauma or shoulder surgery (also following breast re-construction.)
Frozen Shoulder Facts:
- 2-5% of the population.
- It is more common in women (60%)
- It is five times more common in diabetics
- It is more common in patients with Dupytren’s contracture
- It may have a genetic component i.e./ it can run in the family
- It may well have an auto-immune component
- It seems to affect 40-70 year olds (in Japan it is known as 50’s shoulder)
- About 15% of people get it on both sides
How long does it last for?
Symptoms lasts an average of thirty months (some say longer)
There are three phases to frozen shoulder, (which lasts an average of 30 months).
Freezing (1 - 8 months)
Frozen (9 - 16 months)
Thawing (12 - 40 months)
What is happening inside my frozen shoulder?
Inflammation
In a Frozen Shoulder Syndrome the lax capsular sack becomes sticky and can sometimes form adhesions; hence the name of the condition. The stickiness is brought on through inflammation; in my experience this inflammation starts in the groove behind the biceps tendon. (This can occur after a small injury, like reaching for the back seat of the car but often you may not remember anything). Once established this inflammation spreads into other shoulder soft-tissues and can cause swelling in other shoulder sacks (bursae).
Stiffness
The stiffness is an ‘overreaction’ to the inflammation (within the biceps groove). The body seems to ‘switch off’ muscles in a co-ordinated sequence; this sequence is the same for everyone and we call it the ‘capsular pattern’. In less than a week the arm movements start to diminish, and within a few weeks the arm literally becomes frozen and for many, can not be raised more than 40° in any direction. The muscles of the rotator cuff become weak and start slowly to waste away, leaving the arm to hang stiff and immobile.
The good news is that even very severe types of Frozen Shoulder syndrome can be treated simply and effectively by The Niel-Asher technique ®. The technique works by reducing inflammation and re-programming the muscles which have switched off. You can even start working on it yourself from home with our self help products. Better still, all of our excellent and highly qualified Practitioners have an excellent knowledge of the various types of Frozen Shoulder syndrome and how to treat it.
Different type of problems:*
Rotator Cuff Tendinopathy & the Supraspinatus
The rotator cuff is made of four muscles – Supraspinatus, Infraspinatus, Subscapularis and Teres Minor (see Anatomy). These muscles join together and blend to form a muscular cuff at the top and back of the arm. The job of the rotator cuff is to stabilize the ball and socket joint of the shoulder pulling it up and back and holding it into position; this affords a stable base for us to use the arms and hands in manipulating our environment.
The cuff is vulnerable for a number of reasons, especially if you have got a round-shouldered posture. Muscles of the cuff are prone to ware and tear and the tendons can be trapped and damaged, sometimes leading to actual tears and sometimes ruptures. The most common of the cuff muscles to be injured is the Supraspinatus. This is because it sits on top of the shoulder blade and its tendon drops down onto the upper outside of the arm at an angle. The tendon can get rubbed and inflamed, also variations in the under surface of the arch of the shoulder blade (such as osteophytes) can dig into it and sometimes cause tares in the tendon. Another common problem for the Supraspinatus is that the muscle itself is vulnerable to ‘ware and tear’. During the day, the weight of the arm shuts off the blood supply to the muscle and at night, when the arm is off-stretch any damage that has occurred is repaired. This leads to low grade aching and night pain. The area of the muscle most vulnerable to damage (other than the tendon) is in the middle of the belly. Damage and repair to this area can cause a series of repetitive micro-bleeds which when repaired leave behind calcium (chalk) deposits. These chalk deposits can cause a wide range of low-grade problems such as aching and pain and occasionally/rarely the chalk can form a ‘boil’ within the muscle which can burst causing agony. There are two types of chalk soft and hard, and depending on which one you have, there is a different treatment plan.
The good news is that many of the most common Rotator Cuff problems can be treated by a combination of The Niel-Asher technique® and simple exercises. All of our excellent and highly qualified Practitioners have a good knowledge of Rotator cuff problems and how to treat them.
Signs and Symptoms of Rotator Cuff Tendinopathy
- Night pain – sometime relieved by side-lying on the same side
- Weakness on certain movements – especially lifting and rotating the arm
- Catching pain on certain movements
- Able to lift the arm with the other one
- Pain on certain movements on the rear outside of the arm
Advice
- We strongly advise icing the area morning and evening. This couldn’t be easier with our state of the art icepack. For more information click here.
- To help reduce the swelling around the shoulder tendons we advise you use non invasive natural anti-inflammatory medication.
Biceps tendinopathy (long head)
In my opinion, an inflamed (long head) Biceps is often at the root of a frozen shoulder, so it is important to get it treated. The biceps tendon lies in a groove running up the humerus bone of the shoulder.
The biceps tendon is vulnerable to injury in certain positions especially under its retaining transverse ligament.
Symptoms include
- Sharp spasms of pain
- Pain reaching for the back pocket
- Pain reaching for a seatbelt
- Night pain - localized
Advice
- We strongly advise icing the area morning and evening. This couldn’t be easier with our state of the art icepack. For more information click here.
- To help reduce the swelling around the shoulder tendons we advise you use non invasive natural anti-inflammatory medication.
Arthritis
Recent medical research suggests that it is NOT just bones that can get arthritis, but muscles and tendons too – this is known as ‘Peri (or soft tissue) Arthritis’ and results from injury, aging, posture, occupation, sports and ware and tear.
Osteoarthritis is a progressive weakening of the smooth joint cartilage that is designed to allow the joint to move fluidly. The smooth joint surfaces of the ball and socket joint begin to become ‘rusty’. Most of the time the cause is not known, but overuse and injuries can lead to the development of osteoarthritis over time.
Although this condition is more common in other joints (especially the knees and hands), shoulders can become affected by osteoarthritis.
Although we can not cure arthritis, the good news is that the pain and mobility can be helped a great deal by a combination of The Niel-Asher technique® and simple exercises. All of our excellent and highly qualified Practitioners have a good knowledge of arthritis and how to treat it.
Symptoms include
- Stiff shoulder (may appear like a frozen shoulder)
- Painful shoulder – related to movement
- Clicking, crunching or clonking sounds on movement
- Loss of shoulder movement
- (Not usually painful at night)
- Clearly identified on x-ray
Bursitis
The body has many folded bursae throughout. These structures are designed to stop tendons rubbing on muscles or bones. Under certain circumstances these can become inflamed and swollen and this inflammation can linger on and on.
Although we can not promise to ‘cure’ bursitis, the good news is that in most cases it can be helped a great deal by The Niel-Asher technique®. All of our excellent and highly qualified Practitioners have a good knowledge of bursitis and how to treat and manage it.
Advice
- We strongly advise icing the area morning and evening. This couldn’t be easier with our state of the art icepack. For more information click here.
- To help reduce the swelling around the shoulder tendons we advise you use non invasive natural anti-inflammatory medication.
Dislocation
The shoulder is designed for ‘mobility’ and allows a large range of movement, this freedom of motion is however at the expense of ‘stability’. The shoulder is vulnerable in certain ranges of motion and the ball can sometimes ‘slip out’ of the socket. The shoulder can dislocate anteriorly (forward), posteriorly (backward) and superiorly (upward). Unfortunately once you have had one or two bad dislocations the there is often irrevocable damage of the tissues inside the ball and socket joint and the shoulder will require surgery. A truly dislocated shoulder often needs to be ‘put back in’ by a doctor at the A & E department.
Some people are born with anomalies within the joint which makes dislocation more likely, they can pop them in and out as a ‘party’ trick. Also the socket joint of the shoulder has a small cartilaginous cup which holds the ball in place which can be too short and stubby leading to dislocation.
Some people don’t fully dislocate the shoulder but instead, ‘sublux’ their shoulders in what we call ‘atraumatic’ dislocation. This type of dislocation often pops itself back in spontaneously. Although we can not promise to ‘cure’ subluxation, the unique sequence of manipulations performed in The Niel-Asher technique® have been shown to increase the strength and power of the shoulder muscles.
Symptoms of dislocation
- Pain – can be very severe
- Complete or partial loss of function
- Weakness
Painful arc/impingement
This condition is easily confused with a frozen shoulder as there are similarities; however, they are very different problems. Painful arc describes the symptom of pain, when the arm is lifted up to shoulder level and then has a severe crippling spasm of pain. The pain causes immediate weakness and the arm often feels like it needs to be dropped by the side. The MAJOR difference between this and a frozen shoulder is that the arm can actually be raised all the way up once it goes through the painful ‘arc’. In a frozen shoulder the stiffness is there in all directions even when someone else tries to lift the arm. The pain is caused by inflamed tendons being pinched between the top of the ball and the under surface of the collar bone.
Symptoms
- Crippling pain as the arm is raised to shoulder level
- Pain diminishes as push through this point
- Full range of motion
- Night pain especially lying on the same side
- Aching after the pain has gone
- Bursitis
For more information about a range of other shoulder problems, I suggest you visit my colleagues at www.shoulderdoc.co.uk
Reflex Sympathetic Dystrophy (RSD) or CRPS I– What’s that?
Severe cases of Frozen Shoulder Syndrome can be associated with Reflex Sympathetic Dystrophy; now also called complex regional pain syndrome I (CRPS I). This can be a serious and unwelcome complication or it may precede the Frozen Shoulder. It can come on after fracturing the shoulder and or splinting it. It is also associated with shoulder surgery (including manipulation under anaesthetic).
Mostly on the affected side, the massive inflammation in a ‘Freezing’ Shoulder can spread to a nerve bundle at the base of the neck that regulates blood flow to the wrist and hand. This causes a host of more unwelcome symptoms in the hands and fingers:
- We strongly advise icing the area morning and evening. This couldn’t be easier with our state of the art icepack. For more information click here.
- To help reduce the swelling around the shoulder tendons we advise you use non invasive natural anti-inflammatory medication.
Key features of RSD
Hands
- white-blue or reddish, cold, numb, stiff, swollen fingers
- painful & swollen knuckle joints
Other
- increased sweating and odour
- strange odour from arm pit
- severe cramping in shoulder, elbow, wrist, hand
The RSD associated with frozen shoulder syndrome can be effectively addressed with The Niel-Asher Technique™; it usually improves in tandem with the shoulder, but the longer it has been there, the longer it takes to get better. If you think you have RSD you really should consult your doctor and or a qualified Niel-Asher Technique practitioner (for a list of practitioners click here).
Advice
- The Niel-Asher Technique™
- Squeezing a squash ball for 5 minutes 10 times per day
- Putty and hand home exercise products
- Ginko Biloba
- Ruta Gravis & Rhus Tox
- MSM
- Specialized deodorants
More information is available on the following websites
The sooner you seek advice and treatment the better. This is because if you leave RSD too long it can become irreversible. ALTERNATIVELY PLEASE CONSULT YOUR DOCTOR IF YOU THINK YOU HAVE ‘MAJOR RSD’ AS IT MAY REQUIRE SPECIALIST INVESTIGATION.
