Frozen Shoulder

The shoulder is a ball-and-socket joint and has three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone). The head of the humerus fits perfectly into a socket of your scapula. A strong connective tissue, known as the shoulder capsule, surrounds the joint.

To move the shoulder easily, there should be enough synovial fluid to constantly lubricate the joint and the shoulder capsule. Once the shoulder capsule becomes tight, stiff bands of tissue develop, which cause frozen shoulder, also known as adhesive capsulitis.

Frozen shoulders occur in about 5 percent of the population and most often affect people between the ages of 40 and 60. It is more frequent in women.

In a frozen shoulder, the shoulder capsule thickens and becomes tight. The hallmark sign of this condition is being unable to move your shoulder. The condition develops in three stages: First, in the “freezing” stage, pain slowly increases. As the pain worsens, the shoulder loses motion. The freezing lasts from six weeks to nine months.

The second stage is the “frozen” component. Painful symptoms might improve during this stage, but the stiffness remains. During the four to six months of the “frozen” stage, daily activities might be difficult.

Third is the “thawing” stage. Shoulder motion slowly improves, and complete return-to-normal strength and motion typically takes from six months to two years.

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Symptoms, Precautions & Treatments

अंसमूलस्थितो वायुः सिरा संकोच्य तत्रागाः। बाहुप्रस्पन्दितहरं जनयत्यवबाहुकम्॥(अ हृ नि १५/४३)

अंसमूलस्थितो वायुः सिरा संकोच- Constriction in the veins of shoulder joints.

Chesta nasha – Loss offunction of hands

Bahu shosha – Atrophy of arms .

  • Swelling and tenderness of Shoulder
  • Difficulty sleeping on your side
  • Unable to quickly reach for something
  • Pain worsens at night, disrupting sleep
  • Stiffness that does not go away
  • Loss of shoulder function

The causes of frozen shoulder are not fully understood. Frozen shoulders occur much more often in people with diabetes. Additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson’s disease and cardiac disease. Also, a frozen shoulder can develop after a shoulder has been immobilized due to surgery, a fracture or other injury.

रुक्षशीताल्प लघ्वन्न व्यवायाति प्रजागरैः। विषमादुपचाराच्च दोषासृक् स्रवणादतिः॥

लङ्ग्घनाप्लवनात्यध्व व्यायामतिविचेष्टितैः। धातूनां संक्षयाच्चिन्ता शोक रोगाति कर्षणात्॥

दुःखशय्यासनात् क्रोधाद्दिवास्वप्नाद्भयादपि। वेगसंधारणादामादभिघाताद् भोजनात्॥

मर्माघाराद्गजोष्ट्राश्वशीघ्रयानापतंसनाह।(च चि २८/१५-१७)

Vata gets aggravated by the following:
Food (vihara)
Intake of Ruksha(dryness), Sheeta (cold), Alpa (less quantity) and Laghu anna (light-to-digest food)

Vihara:                
Prajagara – Remaining awake at night in excess
Ati plavana – Excessive swimming
Ati langhana – Excessive fasting
Atyadhva – walking for long distance
Ati vyayama – Resorting to wayfaring, exercise and other physical activities in excess.
Dhatu Samkshayaat – depletion of body tissues, loss of Dhatus.

Chinta Shoka karshana – weakening due to excess stress, grief and worries
Roga Ati karshana – Excessive emaciation because of affliction of diseases
Dukha Shayyasana – Sleeping over uncomfortable beds and sitting
Vega vidharana – suppression of natural urges
Krodha (Anger), Diwa swapna (sleep during day time), Bhaya (fear)
Formation of Ama (product of improper digestion and metabolism), suffering from trauma and abstention from food.

  • Prakriti analysis of the patient
  • BAHYA CHIKITSA : (EXTERNAL TREATMENT)

Abhyanga – means performing massage, massage of afflicted part or joint with herbal oils  with mahanaryana taila , Kottamchukkadi taila , dhanwantaram taila , Ksheera bala taila etc

Svedana- (Fomentation / Sudation ) It is type of treatment where sweating is induced , usually done after abhyanga or snehana , among which Bashpa sweda , Sarvanga bashpa sweda , Nadi sweda

 Dhara /seka /Pizhichil : pouring of medicated liquids in steams with gentle stroking for a fixed duration .Greeva basti : warm , medicated liquids are poured for particular time duration within a compartment made at shoulder /cervical region .

Sandhi pichu , Sandhi lepa etc many procedures can be done .

Upanaha – Upanaha means poultices using dry powders

  • ABHYANTARA CHIKITSA (INTERNAL TREATMENT ):

Snehana : intake of medicated oils /ghee

Shodana :                     

Virechana : is given after the snehana  &  svedana .

Vasti – means medicated enemas , for vitiated vata given with kashaya or using oils /ghee.

Nasya : Instilling of medicated drops in nostrils to stimulate  the nerve endings .

Conservative line of management is followed , if patient is not fit for panchakarma , using , rasaraja rasa , malla sindura , Ashwagandha choorna etc,  can be prescribed .     

 As in ayurveda , FROZEN SHOULDERS/Apabahuka is considered among one of the vataja disorders , Diet plan which is followed in vataja disorders goes the same .

Food with Ruksha (Which reduces corpulence ), Avidahi (which are not spicy ), Alavana (not salty), Food should always be fresh and avoid excess food.A low fat milk lactovegetarian diet, which favours sweet , bitter and astringent taste .Diet rich in fruits , vegetables , moderate in protein rich in magnesium , potassium , calcium and fibre .Bananas in plenty –Good source of  potassium.Coconut water – which has good quantities of potassium & magnesium.Ginger –cardamom tea.Eating water melon or drinking melon juice .Frequent self massage with oil

Pranayama

Yoga

  • Excessive intake of alchohol/salt and pungent foods.
  • Do not eat until the previous food is not digested.Complete eliminate from coffee , tobacco, pan .
  • Day time sleep must be avoided .Anger , jealousy, frustration , must be avoided.

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