The following characteristics are associated with the various types of glenohumeral joint (GH) arthritis that lead to hypomobility. Your shoulder pain may not be arthritis! stop assuming😆. having pain in the shoulder? I better suggest you to stop browsing and give a good visit to your orthopedics or Physiotherapist!
- Acute phase. usually, external rotation and abduction are guarded by pain. Pain is frequently experienced radiating below the elbow and may disturb sleep during the night. Owing to the depth of the capsule, joint swelling is not detected, although tenderness can be elicited by palpating in the fornix immediately below the edge of the acromion process between the attachments of the posterior and middle deltoid.
- Subacute phase. Capsular tightness begins to develop. Limited motion is detected, consistent with a capsular pattern (external rotation and abduction are most limited, and internal rotation and flexion are least limited). Often, the patient feels pain as the end of the limited range is reached. Joint-play testing reveals limited joint play. If the patient can be treated as the acute condition begins to subside by gradually increasing shoulder motion and activity, the complication of joint and soft tissue contractures can usually be minimized.
- Chronic phase. Progressive restriction of the GH joint capsule magnifies the signs of limited motion in a capsular pattern and decreased joint play. There is a significant loss of function with an inability to reach overhead, outward, or behind the back. Aching is usually localized to the deltoid region.
Frozen Shoulder
Idiopathic frozen shoulder. This clinical entity progresses through a series of four stages following a classic continuum.
- Stage 1. Characterized by a gradual onset of pain that increases with movement and is present at night. Loss of external rotation motion with intact rotator cuff strength is common. The duration of this stage is usually less than 3 months.
- Stage 2 (Often referred to as the “Freezing” Stage). Characterized by persistent and more intense pain even at rest. Motion is limited in all directions and cannot be fully restored with an intra-articular injection. This stage is typically between 3 and 9 months.
- Stage 3 (“Frozen” Stage). Characterized by pain only with movement, significant adhesions, and limited GH motions, with substitute motions in the scapula. Atrophy of the deltoid, rotator cuff, biceps, and triceps brachii muscles may be noted. This stage is between 9 and 15 months.
- Stage 4 (“Thawing” Stage). Characterized by minimal pain and no synovitis but significant capsular restrictions from adhesions. The motion may gradually improve during this.
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