What cause frozen shoulder pain?

The shoulder girdle will be rigid because the joint's free movement becomes difficult in a frozen shoulder. In medical terms, it's known as adhesive capsulitis of shoulder joint. Shoulder pain could occur after an injury or because of overuse or by a disease like diabetes. The tissues around the joint become stiff, scar tissue forms, and shoulder movements become painful and difficult. The condition usually comes on gradually and then goes away gradually over a year or longer.

Osteoarthritis (OA) is a form of arthritis in the joints when the cartilage cushioning the bones' ends loses its elasticity slowly and wears away. When there is no covering cartilage, the bones begin to grind against one another, causing stiffness, swelling, and mobility loss. Osteoarthritis treatment with current traditional medicine typically focuses on pain reduction and inflammation control. These approaches don't impact the natural course of this disease.

Osteoarthritis can be another cause. It is the most common type of arthritis globally, with symptoms ranging from minor discomfort to debilitation. It can happen in almost any of the body's joints but most often develops in the palms and weight-bearing joints, including the knees, hips, and spine (usually in the neck or lower back). For people dealing with rheumatoid arthritis, the consequences aren't just physical but also psychological as pain and decreasing freedom can restrict the ability to operate, participate in daily activities with family and friends, and enjoy life.

Science does not have any clear answers about what causes frozen shoulder or OA. However, researchers have identified several factors involved in the development and course of OA. Some of the factors include biomechanical imbalances that place stress on the joints. 

In Ayurveda, this problem is connected to Apabahuka.

See: Acupuncture helps a case of neck pain and frozen shoulder

Frozen shoulder pain causes

Frozen shoulder causes:

The bones, tendons, and ligaments that make up your shoulder joint are encased in the connective tissue capsule. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, limiting its movement.

Experts aren't certain why this happens to some people, even though it's more likely to happen in those who have diabetes or those who recently had to trap their shoulder for a long duration, like following surgery or an arm fracture. The thickening and consequent tightening of the shoulder joint capsule could be due to the following reasons:

After the result of injury 

Overuse of the joints (exercise, weight lifting, or excess physical exertion on the shoulders)

Chronic conditions like diabetes

Degenerative ailments effects, like in chronic rheumatoid arthritis, cervical spondylosis

Ayurveda's view of frozen shoulder pain:

Apabahuka is a disorder that usually affects the Amsa sandhi (shoulder joint). It is created by the Vata dosha. Even though Apabahuka isn't cited in the Nanatmaja Vata vyadhi (Diseases that arise solely because of Vata Dosha), Acharya Sushruta, and many others have considered Apabahuka as a Vataja Vikara. Amsa shosha (squandering of the shoulder) can be regarded as the preliminary phase of the disease. Kapha Dosha contributes the stiffness into the joints.

Due to the participation of Kapha Dosha, in most individuals, cold exposure and at night, the stiffness dissipates.

The tissues around the shoulder joint are stiffened due to one of the causes. The scar tissue is developed around the construction of the joints. This results in the restriction of the moves to the shoulder joint. On moving, pain is felt, and mobility is restricted. Causes for frozen shoulder according to Ayurveda include internal and external triggers.

- Internal triggers: Vata aggravating diet and actions. Excess of bitter and astringent tasting foods.

- External triggers: Injury to the Crucial parts of the body (marma) or the area surrounding the shoulder joint, or sleeping with incorrect posture

See: Acupuncture relieves Muscloskeletal Pain and shoulder movement

Ayurvedic frozen shoulder pain treatment

Ayurvedic approaches to shoulder pain healing

Given the moderate effectiveness and possible side effects of conventional therapy, patients and healthcare professionals look for alternative therapies such as Ayurveda. Ayurveda helps treat shoulder mobility and other ailments with Agnikarma, herbal remedies, massages, meditation, and yoga.

Agnikarma (Thermal Microcautery) is an ancient medical procedure that has been well-described in Ayurveda, the Indian System of Medicine. An Indian surgeon, Maharshi Sushruta, called the father of modern surgery, recorded the power of the Agnikarma (Thermal Microcautery) process for various musculoskeletal disorders from the early Ayurveda literature of Sushruta Samhita about 2500 years back.

In today's modern world, the most common cause of disability is that the incidence of musculoskeletal disorders like osteoarthritis, sciatica, spondylosis, frozen shoulder, etc.. Long-term muscular and joint distress may result in psychological distress and often negatively influence the quality of life. Modern medical drugs provide symptomatic relief, but modern medications' chronic use can be associated with severe side effects.

The Agnikarma (Thermal Microcautery) technique, on the other hand, is an extremely effective treatment for musculoskeletal diseases that can provide quick relief without side effects or complications. It's a minimally invasive economical procedure that can decrease the need for surgical interventions.

What is the Agnikarma procedure?

Agnikarma process involves thermal micro-cauterization utilizing a technical Agnikarma Unit (Thermal Microcautery Unit) or a metallic tool named Agnikarma Shalaka. First, based on the individual's constitution, the identification and severity of the disease, certain points are identified in the body area. The heated tip of the Agnikarma Shalaka is implemented precisely to the affected area, followed by the application of holistic lotions for immediate cooling relief.

After the treatment, clients can carry on with their everyday activities. Follow-up therapy may be required depending on the seriousness of the condition.

The Agnikarma process, if carried out improperly, can cause complications. It is crucial that a trained Ayurvedic Practitioner always carried out the procedure with particular expertise in Agnikarma.

Indications of agnikarma or thermal microcautery treatment

Agnikarma is an effective treatment for both chronic and acute pain conditions such as:

Knee pain (osteoarthritis of the knee)

Lower Back pain

Sciatica

Lumbar Spondylosis

Cervical Spondylosis

Frozen shoulder

Synovitis

Slipped disc (prolapsed disc)

Tennis Elbow

Carpal Tunnel Syndrome (CTS)

Myofascial pain

Rheumatoid Arthritis

Tendonitis

Migraine, Headache

Heel pain (Plantar fasciitis, calcaneal spur)

Gout

Trigger Finger

- Benefits of agnikarma (thermal microcautery) treatment

Quick and long term pain relief

No side-effects

OPD based process (no hospitalization required)

Well-tolerated by sufferers

Cost-effective

See: Ayurveda for Osteoarthritis treatment

Ayurvedic massages & herbal therapies

Ayurvedic therapies of shoulder pain:

- Oleation (Snehana) -- into the shoulder girdle from the back of the neck to the corresponding arm's tip, is usually beneficial.

- Swedana (Sudation) -- Following the oleation, gentle sudation should be carried from the oleated area; this stimulates the nerve endings and enhances blood flow too. The stiffness and pain are relieved as a result.

- Nasya (oleagenous errhines) may significantly affect this state since it stimulates the nerve endings.

- Basti therapy (rectal enema with oils / herbal decoctions) may have to quickly bring about a Vata balance.

Ayurvedic procedures useful in frozen shoulder pain management: The following treatments can relieve pain and stiffness of joints and heal the degenerated connective tissues.

Abhyanga oil massage. The medicated oils are given below. Usually, oils are somewhat heated within a water bath before massage. Usually, steam treatment is given after massage, particularly to alleviate stiffness.

Pizhichil -- streaming of hot oil, together with simultaneous massage.

Elakizhi -- herbal poultice, are ready with Vata balancing herbs like castor leaves, Nirgundi (Vitex negundo), Devadaru, Dashamoola, tied in a bunch by fabric. This fabric is dipped in hot medicated oil, and this is used over the shoulder joints.

Njavarakizhi -- Especially helpful in degenerative problems. Once Abhyanga (oil massage) is completed, a rice package, dipped in certain kashayams), made with fabric, is applied over the affected region.

Podi Kizhi -- herbal powders taken in linen bags, dipped in oil and implemented over shoulder joint

Pichu -- Cloth or cotton swabs soaked in hot medicated oil applied to the affected joint. 

Ayurvedic medicated herbal oils for massage

Herbal oils that are effective for frozen shoulder:

Vishagarbha Taila -- used in treating paralysis, stiffness of hands and legs, neck stiffness.

Dhanwantara Taila is used in treating Vata diseases like Rheumatoid and osteoarthritis, spondylosis, headache, and neuro-muscular problems.

Bala Taila -- Nourishing in character. Useful to reverse osmosis.

Prasaranyadi Taila -- Especially beneficial to relieve stiffness.

Maha Narayana Taila is an effective herbal oil used in treating arthritis, paralysis, and eye disorders. This oil can be used for external application, orally, and many Ayurvedic therapies.

Kottamchukkadi Taila is an Ayurvedic oil used in treating Vataja ailments, causing sciatica, neuromuscular pains, spondylosis, etc. This oil is formulated according to Kerala Ayurveda practice.

Ayurvedic formulas that can help include:

Yogaraja Gulgulu -- Useful in bringing down pain and to enhance joint flexibility

Rasnaerandadi Kashaya -- Useful if there is joint pain with stiffness

Shilajatu Vati -- Useful if there is tissue degeneration

Prasaranyadi Kashaya and Sahacharadi Kashaya -- Useful particularly when there is stiffness.

Maharasnadi Kashaya -- Relieves inflammation and pain

Dashamoolarishta-- to alleviate inflammation quickly

Vatavidhwamsa Rasa -- used in the treatment of neuritis, colic pain, etc

Mahavatavidhwamsa Rasa -- used in treating Vata disorders, such as abdominal pain.

Vishamushti Vati

Recovery can be supplemented with physiotherapy and yoga. 

Ayurvedic healthy diet and lifestyle in the frozen shoulder:

Warm and unctuous food

Proper and regular exercise

Warm water bath loosens the stiffness.

Include anti-inflammatory spices like turmeric and black pepper in the diet.

Avoid unhealthy habits and diets in the frozen shoulder:

Excess of fatty and fried food

Cold water bath

Extra cold A/C 

Heavy exercise

Improper laying, sitting, and sleeping posture

Frozen shoulder isn't a life-threatening illness. However, the condition will be miserable because daily life is significantly impacted. Also, it causes difficulty in performing his specialist works as in every work role of the shoulder and hand is surely needed. So immediate attention and routine medication, and continuous exercises play an important role in this disease.

See: Ayurvedic Massage

Physiotherapy & yoga for shoulder pain

- Physiotherapy for shoulder pain

Physiotherapy for a frozen shoulder is quite helpful. There are specific exercises that the physiotherapist will make one do. However, there are a few that you can do at home to enhance shoulder joint flexibility.

Always begin with the easiest one and stop if mild pain begins to appear.

Arm rotation exercises - clockwise and anti-clockwise for 5 rounds.

While sitting straight, extend your arms straight. Hold for 5 minutes and relax.

While sitting straight, extend your arms straight. Hold for 5 minutes and relax.

- Yoga asanas for frozen shoulder include:

Surya Namaskara

Pashasana

Trikonasana

Adhomukha Shwanasana

Ushtrasana

Gomukhasana

- Home remedies to prevent freezing shoulders

Do routine rotatory arm exercises.

Avoid constant computer work, move frequently.

Oil massage with a hot water bath or steam at least once a week.

Regular exercises and physical activity

See: Turmeric Curcumin Health Benefits & Side Effects

Ayurvedic herbal treatments for inflammation

Ayurveda offers many herbal remedies for healing shoulder pain. These plants have anti-inflammatory properties with no side effects. The American College of Rheumatology stated that Ayurveda provides "safe and effective treatment options" for OA. The herbs Boswellia, turmeric, Triphala, Guggulu, ashwagandha, ginger, and Shatavari have been shown to reduce inflammation as they interfere with the production of inflammatory compounds bodies.

See: Shatavari Root & Powder Benefits,Uses, Side Effects

References


1. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684

2. Acheson RM, Collart AB. New Haven survey of joint diseases. XVII. Relationship between some systemic characteristics and osteoarthrosis in a general population. Ann Rheum Dis. 1975;34:379–87. [PMC free article] [PubMed] [Google Scholar]

3. Acharya JT, editor. Reprint ed. Varanasi: Chaukhambha Prakashan; 2009. Charaka Samhita of Agnivesha, Chikitsa Sthana, Ch.25, Ver. 40; p. 132. [Google Scholar]

4. Doherty M, Jones A, Cawston T. Osteoarthritis. In: Isenberg DA, editor. Oxford Textbook of Rheumatology. 3rd ed. Oxford: Oxford University Press, 2004; 2004. pp. 1091–118. [Google Scholar]

5. Acharya JT, editor. Reprint ed. Varanasi: Chaukhamba Surbharti Prakashan; 2009. Sushruta Samhita of Sushruta, Sutra Sthana, Ch.46, Ver. 524; p. 252. [Google Scholar]

6. Mahajan A, Verma S, Tandon V. Osteoarthritis. J Assoc Physicians India. 2005;53:634–41. [PubMed] [Google Scholar]

7. Acharya JT, editor. Reprint ed. Varanasi: Chaukhambha Prakashan; 2009. Charaka Samhita of Agnivesha, Sutra Sthana, Ch.25, Ver. 40; p. 132. [Google Scholar]

8. McLean DA. The use of cold and superficial heat in the treatment of soft tissue injuries. Br J Sports Med. 1989;23:53–4. [PMC free article] [PubMed] [Google Scholar]

9. Acharya JT, editor. Reprint ed. Ch. 10, Ver. 17. Varanasi: Chaukhambha Prakashan; 2009. Charaka Samhita of Agnivesha, Sutra Sthana; p. 67. [Google Scholar]

10.  Mahajan A, Tandon V, Verma S, Sharma S. Osteoarthritis and menopause. J Indian Rheumatol Assoc. 2005;13:21–5. [Google Scholar]

See: Guggul health benefits & side effects

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