By Dr. Nayeem U Zia
Patients with frozen shoulder have a painful restriction of shoulder joint motion in all planes. This condition most commonly occurs in older adults, with a higher incidence in females. It is associated with medical conditions such as diabetes, ischemic heart disease, inflammatory arthritis, and cervical spondylosis. It is also affiliated with extended immobilisation and trauma.
Kashmir Valley perspective
The Department of Physiotherapy at Government District Hospital Baramulla, Kashmir, conducted a census of total patient visits in the first quarter of calendar year 2016. The data revealed that a plethora of patients presented complaints related to the shoulder joint. A significant chunk (approximately 30 percent) upon examination represented the frozen shoulder category and most of the patients were young adults. Despite the fact that frozen shoulder is universal, it is epidemically prevalent in our society. It seems frozen shoulder has a predilection for people living in the Valley.
Though a lot of factors can be attributed to that, the most inherent characteristic of living in the Valley is stingy joint movements. Limited movements at shoulders can be ascribed to multiple layers of clothing given the harsh nature of weather. Restricted joint freedom results in loss of extensibility of joint capsule and weakness in the muscles around shoulder joints. Prolonged reduction in the movements puts us at a higher risk of developing frozen shoulder than people from other areas. Given the nature and architecture of the joint capsule, limited movement in shoulder joints in itself is an issue. Moreover, most daily activities do not necessitate a full arc of motion at the shoulder joint, particularly in white collar workers. Also, in the wake of technological advancement and changing lifestyles one indulges in fewer activities through the day.
Eventually, the strength of muscles around the shoulder joint and flexibility of the joint capsule are compromised. A decade ago, it was beyond one’s contemplation that people in their thirties would be afflicted with frozen shoulder, but this has become a reality now. Diabetes and injuries at or around the shoulder joint alone cannot be held responsible for it, but changing lifestyle is equally culpable. Needless to say, we as a society rapidly fall prey to innovations in lifestyle. We hardly invest time in remaining physically active in the era of technological progress.
On a lighter note: patients with frozen shoulder present a common complaint in the vernacular language: “Doctor saeb, mae naez banaan yemi lari shungnui…raatas che aasan dagh” (I cannot turn and sleep on the affected side as it causes dreadful pain).
Let us be realistic in not reprehending the cold weather alone. The time has come to be pragmatic and more importantly proactive in fighting this malady in order to impart quality to our lives. Optimistically, we still have room to resort to the realm of “Being Active”, or else the scope for reclamation is quite bleak.
Prevention is the best cure. Keep moving your shoulders not only in the range required for daily living but beyond too. Strengthen the shoulders under supervision and consult experts to keep a tab on your posture. One can forestall living with pain by making it a routine affair. Furthermore, healthcare professionals shoulder the moral obligations towards society in terms of underscoring the importance of physical activity in a healthy life.
—The writer is a physiotherapist at district hospital, Baramulla