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Frozen Shoulder and Shoulder Impingement Syndrome

To understand the difference between Frozen Shoulder and Shoulder Impingement Syndrome, we will first look at with the symptoms of shoulder impingement syndrome.

Shoulder impingement syndrome is characterized by pain when taking the arm away from the body at the sides of the shoulder (abducting is the technical term).

With shoulder impingement, the tendons in the sub acromial space between the top of the upper arm bone and the acromion are squeezed. This causes an inflammation of the supraspinatus tendon (a tendon of the rotator cuff).

As the tendon inflames, it swells and every time you move your arm above your head, it catches and you get sharp pain.

These movements are classic in swimming, throwing a ball, painting and decorating, carpentry or where things are lifted over the head. Eventually this leads to restriction in lifting your arm to the side, and severe weakness.

The pain of shoulder impingement syndrome occurs over the outer aspect of the shoulder joint involved, and often the upper arm. If the pain is severe enough, it may radiate to the elbow. Usually it does not extend below the elbow.

The pain is often worse in the night particularly when sleeping on the affected side. The affected individuals often complain that the pain from impingement “catches” them at certain movements.

Having understood the nature of shoulder impingement syndrome, it is easy for us to understand why it is often confused with frozen shoulder.

Frozen shoulder also has symptoms much similar to shoulder impingement syndrome.

In frozen shoulder, the capsule and soft tissues around the joint undergo inflammation and stiffness resulting in shoulder pain, grossly restricted movements of the shoulder, night pains, pain during rest and joint stiffness.

The joint stiffness initially restricts the abduction of the shoulder and later on other movements as well.

All the above symptoms also occur in shoulder impingement syndrome, despite being a different entity altogether. But differentiating them from one another is of utmost importance in planning the management.

Also, the outcome of both diseases is different. While frozen shoulder tends to recover spontaneously in around 18 to 36 months with or without treatment, similar luxury does not exist for shoulder impingement syndrome. So mistaking a severe shoulder impingement syndrome for frozen shoulder and adopting a “wait and watch” policy is very deleterious for the well being of the affected individual.

To help further differentiate between the two, it is a good idea to make sure that your doctor orders shoulder X-rays. This will rule out some of the issues behind frozen shoulder. Treatment involves anti-inflammatory medications, osteopathy or physiotherapy, and rest. If there are, bone spurs than surgery may be necessary to remove them.

This is significantly different from frozen shoulder even if there are similar symptoms.

It is a good idea to be aware of the variety of issues, which may arise from a particular set of symptoms. It gives you the opportunity to be able to talk with your doctor about the various options of what could be wrong and know the various types of treatments available to you.

Often general practitioners will not totally understand the processes involved in shoulder impingement syndrome, so it may be necessary to see a good osteopath or physical therapist.

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