DefinitionFrozen shoulder is when the shoulder is painful and loses motion because of inflammation.Alternative NamesAdhesive capsulitisCauses, incidence, and risk factorsThe capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint.Most of the time there is no cause for frozen shoulder. Risk factors include:Cervical disk disease of the neckDiabetesShoulder injuryShoulder surgeryOpen heart surgery Thyroid problemsSymptomsThe main symptoms are:Decreased motion of the shoulderPainStiffnessFrozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. Lack of movement leads to stiffness and then even less motion. Over time, you become unable todo movementssuch as reaching over your head or behind you.Signs and testsThe health care provider willask aboutyour symptoms and an examine your shoulder. A diagnosis is often made when youare not able torotate your shoulder.You may have x-rays of the shoulder. This isto make sure there is no other problem, such as arthritis. Sometimes an MRI exam shows inflammation.But imaging tests do not show specific signs to diagnose frozen shoulder.TreatmentPain is treated with nonsteroidal anti-inflammatory medications (NSAIDs) and steroid injections. Steroid injections plus physical therapy can improve your motion.It can take a few weeks to see progress. It may take as long as 6 – 9 monthsfor complete recovery. Physical therapy is intense and needs to be done every day.Left untreated, the conditionoften gets better by itself within 2 years with little loss of motion.advertisementRisk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated.Surgery is recommended if nonsurgical treatment is not effective. This procedure (shoulder arthroscopy) is done underanesthesia. During surgery the scar tissue is releasedby bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, you may receive pain blocks so you can participate in physical therapy.Expectations (prognosis)Treatment with physical therapy and NSAIDs will usually restore motion and function of the shoulder within a year. Even untreated, the shoulder can get better by itself in 24 months.After surgery restores motion, you must continue physical therapy for several weeks or months to prevent the frozen shoulder from returning. Treatment may fail if you cannotkeep up withphysical therapy.ComplicationsStiffness and pain continue even with therapyThe arm can break if the shoulder is moved forcefully during surgeryCalling your health care providerIf you have shoulder pain and stiffness andthink you have a frozen shoulder, contact your health care provider for referral and treatment.PreventionThe best way to prevent frozen shoulder is to contact your health care provider if you develop shoulder pain that limits your range of motion for an extended period. Early treatment and helpsprevent stiffness.People who have diabetes will be less likely to get frozen shoulder if they keep their condition under control.ReferencesMiller RH, Dlabach JA. Shoulder and elbow injuries. In: Canale ST, Beatty JH, eds. Campbells Operative Orthopaedics. 11th ed. Philadelphia, PA: Elsevier Mosby; 2007:chap 44.Krabak BJ, Banks NL. Adhesive capsulitis. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2008:chap 10.Review Date:11/15/2012Reviewed By:C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
Prime Minister Andrew Holness in Parliament last evening (May 15) outlined several measures to improve water production capacity in Kingston and St. Andrew. At present the water levels in the Mona Reservoir is at 27 Percent and the Hermitage Dam, 33 percent. The Government is moving to do major upgrades of the water transmission systems while looking to source new wells and springs and establish a new water treatment plant from Rio Cobre, to assist in alleviating the water shortage in the Corporate Area.Prime Minister Andrew Holness in Parliament last evening (May 15) outlined several measures to improve water production capacity in Kingston and St. Andrew. At present the water levels in the Mona Reservoir is at 27 Percent and the Hermitage Dam, 33 percent.Prime Minister Holness said the major upgrade of the transmission system and the construction of a 15-million-gallon water treatment plant on the Rio Cobre in St Catherine will improve water supply and meet future water needs.The Prime Minister said it will cost some US$160 million to upgrade some water distribution systems in the Corporate Area.“We are nearing completion of the water works along both Hagley Park Road and Constant Spring Road. Once finished, we will see upgraded transmission mains and a more reliable system of distribution in the areas”, stated Prime Minister Holness.Prime Minister Holness expressed hope for rainfall in the coming months to increase the water levels in the storage facilities.“We are hoping that when the heavens do open and the rains come, we will be in a better position to save this precious resource and to improve the conditions of our people. We also urge persons to conserve where possible as this too will help in these difficult times”, said Prime Minister.In the meantime, Prime Minister Holness said he is aware of the cries of homeowners and business operators within the Corporate Area and sections of St. Catherine, bemoaning the lack of sufficient supply of potable water.“I am faced with the issues first-hand as my Constituency is one that consistently suffers from the lack of a reliable supply of potable water. We understand the great level of frustration and inconvenience this has caused in affected households and places of business and we appreciate the patience and understanding being experienced by residents”, said Prime Minister Holness.The Prime Minister apologized to the country for the shortage of water that has inconvenienced residents across the Corporate Area for several weeks. Story Highlights Prime Minister Holness said the major upgrade of the transmission system and the construction of a 15-million-gallon water treatment plant on the Rio Cobre in St Catherine will improve water supply and meet future water needs. The Government is moving to do major upgrades of the water transmission systems while looking to source new wells and springs and establish a new water treatment plant from Rio Cobre, to assist in alleviating the water shortage in the Corporate Area.