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Can Diabetes Cause Shoulder Impingement

Thawing Out That Frozen Shoulder

Thawing Out That Frozen Shoulder

Having trouble reaching behind your back? Do you struggle to button your shirt or tie your necktie? Does your shoulder hurt more at night while you’re trying to sleep? Is your golf game suffering because of shoulder pain? If so, you might be experiencing a painful — yet common — condition called adhesive capsulitis, also known as “frozen shoulder.” Read on to learn more about it, including treatment options. What is frozen shoulder? Frozen shoulder is a condition that causes pain and stiffness in your shoulder joint. Over time, the ability to move your shoulder is reduced, and it may get to the point where your shoulder literally becomes “frozen.” Frozen shoulder is not the same thing as arthritis, however. Your shoulder joint is a ball and socket joint, much like your hip joint. The joint is covered by a capsule of ligaments. When frozen shoulder occurs, it means that the capsule and ligaments swell and become tight, making it difficult — or even impossible — to move your shoulder. Who’s at risk for frozen shoulder? People between the ages of 40 and 60 are more likely to have frozen shoulder, and this condition affects women more than men. In addition, you have a higher risk of it if you’ve had the following: • Rotator cuff injury • Broken arm • Stroke • Shoulder injury • Surgery Certain medical conditions also increase the likelihood of frozen shoulder, including: • Diabetes • Thyroid disease (under- or overactive thyroid) • Heart conditions • Parkinson’s disease • Tuberculosis • Hormonal changes As you can see, having diabetes is a risk factor. It’s thought that uncontrolled blood sugars may cause changes in connective tissue, which, in turn, can boost your chances of this painful condition. According to the American Di Continue reading >>

Adhesive Capsulitis: A Review

Adhesive Capsulitis: A Review

Adhesive capsulitis is a common, yet poorly understood, condition causing pain and loss of range of motion in the shoulder. It can occur in isolation or concomitantly with other shoulder conditions (e.g., rotator cuff tendinopathy, bursitis) or diabetes mellitus. It is often self-limited, but can persist for years and may never fully resolve. The diagnosis is usually clinical, although imaging can help rule out other conditions. The differential diagnosis includes acromioclavicular arthropathy, autoimmune disease (e.g., systemic lupus erythematosus, rheumatoid arthritis), biceps tendinopathy, glenohumeral osteoarthritis, neoplasm, rotator cuff tendinopathy or tear (with or without impingement), and subacromial and subdeltoid bursitis. Several treatment options are commonly used, but few have high-level evidence to support them. Because the condition is often self-limited, observation and reassurance may be considered; however, this may not be acceptable to many patients because of the painful and debilitating nature of the condition. Nonsurgical treatments include analgesics (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs), oral prednisone, and intra-articular corticosteroid injections. Home exercise regimens and physical therapy are often prescribed. Surgical treatments include manipulation of the joint under anesthesia and capsular release. Adhesive capsulitis is a common, painful condition of the shoulder that is associated with loss of range of motion in the glenohumeral joint. It results from contraction of the glenohumeral joint capsule and adherence to the humeral head.1,2 The term “frozen shoulder” commonly used to describe adhesive capsulitis and other conditions associated with loss of range of motion at the joint. Although adhesive capsulitis i Continue reading >>

Shoulder Pain

Shoulder Pain

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Shoulder Pain article more useful, or one of our other health articles. In this article Shoulder pain is a common symptom in primary care. It can be due to an intrinsic shoulder problem but pain can also be referred from other structures, such as the neck, diaphragm or the heart. Common shoulder problems share overlapping clinical features. When assessing shoulder pain, it is important to look for any 'red flags' that mean investigation and diagnosis need a more focused or urgent approach. Anatomy of the shoulder joint The humerus, glenoid, scapula, acromion, clavicle and surrounding soft tissues make up the shoulder. There are three significant articulations: the sternoclavicular joint, the acromioclavicular joint and the glenohumeral joint. The glenohumeral joint is the most commonly dislocated major joint in the body. Ligaments and surrounding musculature, including the rotator cuff muscles, contribute to shoulder joint stability. The rotator cuff is composed of the four muscles: supraspinatus, infraspinatus, teres minor and subscapularis that interlock to function as one unit. These muscles help with internal and external rotation of the shoulder and importantly depress the humeral head against the glenoid as the arm is elevated. The tendons join together to form one tendon, the rotator cuff tendon. This passes through the subacromial space. The subacromial bursa, which has a large number of pain sensors, fills the space between the acromion and the rotator cuff tendon.[1] Shoulder pain is the third most common cause of musculoskeletal consultation Continue reading >>

Frozen Shoulder

Frozen Shoulder

Tweet Frozen shoulder, also known as adhesive capsulitis, occurs when ligaments around the shoulder joint swell and become stiff. The inflammation of this tissue can make normal healing hard and result in your shoulder being so stiff that everyday activities can be troublesome, such as buttoning your shirt. Frozen shoulder can be very painful for sufferers, which is normally followed by increasing stiffness after around nine months. Symptoms can get worse over a number of months and years and greatly affect movement. Patients with frozen shoulder can ease their symptoms, but this can sometimes take several years. Connection with diabetes Research has shown that people with diabetes are up to twice as likely to suffer from frozen shoulder. Dr. Richard Bernstein reports this is due to effects on collagen in the shoulder, which holds the bones together in a joint. Collagen can become sticky if sugar molecules become attached, resulting in movement being restricted and the shoulder beginning to stiffen. This process is known as glycosylation. Poorly controlled diabetes has long been linked to muscular and skeletal problems, with consistently high blood sugars likely to increase the risk of complications such as frozen shoulder. Symptoms of frozen shoulder Pain and stiffness are the two main symptoms of frozen shoulder, which can vary from being mild to severe enough that you may not be able to move your shoulder. Symptoms typically affect patients across three different stages: Stage one: Freezing (lasts between six weeks to nine months) - your shoulder will become very painful and can result in range of motion being lost Stage two: Frozen (lasts between four to 12 months) - your pain may ease, but your shoulder could become increasingly stiff Stage three: Thawing (lasts be Continue reading >>

Shoulder Impingement

Shoulder Impingement

Shoulder impingement is a very common cause of shoulder pain, where a tendon (band of tissue) inside your shoulder rubs or catches on nearby tissue and bone as you lift your arm. It affects the rotator cuff tendon, which is the rubbery tissue that connects the muscles around your shoulder joint to the top of your arm. An impinging shoulder will often improve in a few weeks or months, especially with the right type of shoulder exercises, but occasionally it can be an ongoing problem. Shoulder impingement can start suddenly or come on gradually. pain in the top and outer side of your shoulder pain that's worse when you lift your arm,especially when you lift it above your head pain or aching at night, which can affect your sleep Read about other causes of shoulder pain . See your GP if you have shoulder pain that doesn't go away after a few weeks or is stopping you from doing your normal activities. Your GP will look at your shoulder and ask you to move your arm in differentways to see how easily you can move it and if movement makes the pain worse. They may suggest some treatments you can try orrefer you to a physiotherapist for treatment advice. You probably won't need to go to hospital for any scans. You can also go straight to a physiotherapist without seeing your GP, but you might need to pay. Read about finding a physiotherapist . Avoidthings that makethe painworse avoid activities that involverepeatedly lifting your arm above your head (such as swimming orplaying tennis) for a few days or weeks. Ask your GP or physiotherapist when you can restart these activities. Don't stop moving your arm completely try to carry on with your normal daily activities as much as possible so your shoulder doesn't become weak or stiff. It's usually best to avoid using a sling. Hold an Continue reading >>

Shoulder Problems Linked To Cardiovascular And Pre-diabetes Risks! Fracture Stability With Nail Plate Combination

Shoulder Problems Linked To Cardiovascular And Pre-diabetes Risks! Fracture Stability With Nail Plate Combination

Painful Shoulders Associated With Increased Risk for Heart Disease New work from the University of Utah School of Medicine finds that people with symptoms indicating an increased risk for heart disease could be more likely to have shoulder problems. "If someone has rotator cuff problems, it could be a sign that there is something else going on. They may need to manage risk factors for heart disease, " says the study's lead author Kurt Hegmann, M.D., professor of Family and Preventive Medicine and director of the Rocky Mountain Center for Occupational and Environmental Health, in the December 26, 2016 news release. Dr. Hegmann told OTW, I noticed comparatively poor epidemiological studies of common musculoskeletal disorders. Studies were almost never prospective cohort studies, populations were small, case definitions in publications were poorly described or irreproducible, exposures were usually questionnaire-based and confounders, sometimes including obvious ones, went unaddressed. Regarding studying shoulder disorders, we know that normal tendons never rupture. When we see a ruptured tendon (Achilles, supraspinatus, etc.), we know that it was degenerative even if there were no symptoms. Experimental studies show the weak point when loading the muscle-tendon unit is either the muscle-tendon junction (i.e., a true muscle strain) or the bone-tendon junction (i.e., where a fleck of bone comes off). [Richard] Rothman in 1966, as well as other researchers, quantified that there is poor blood supply in the supraspinatus where rotator cuff tendon tears occur. Thus, vascular insufficiency is one of the two main mechanistic theories of rotator cuff (RC) tears. The other main theory of rotator cuff tears is mechanical abrasion or impingement that was first described in the 1920 Continue reading >>

Frozen Shoulder

Frozen Shoulder

Frozen shoulder or adhesive capsulitis is a common source of shoulder pain. While frozen shoulder is commonly missed or confused with a rotator cuff injury , it has a distinct pattern of symptoms resulting in severe shoulder pain, loss of shoulder function and eventually stiffness. The more precise medical term for a frozen shoulder is "adhesive capsulitis". In basic terms, it means that your shoulder pain and stiffness is a result of shoulder capsule inflammation (capsulitis) and fibrotic adhesions that limit your shoulder movement. Unfortunately, there is still much unknown about frozen shoulder. One of those unknowns is why frozen shoulder starts. There are many theories but the medical community still debates what actually causes frozen shoulder. Frozen shoulder causes your shoulder joint capsule to shrink, which leads to pain and reduced range of shoulder movement. Your shoulder capsule is the deepest layer of soft tissue around your shoulder joint, and plays a major role in keeping your humerus within the shoulder socket. Frozen shoulder has three stages, each of which has different symptoms. Freezing characterised by pain around the shoulder initially, followed by a progressive loss of range of movement. Known as the RED phase due to the capsule colour if you undergo arthroscopic surgery. Frozen minimal pain, with no further loss or regain of range. Known as the PINK phase due to the capsule colour if you undergo arthroscopic surgery. Thawing gradual return of range of movement, some weakness due to disuse of the shoulder. Known as the WHITE phase due to the capsule colour if you undergo arthroscopic surgery. Each stage can last on average 6 to 8 months if left untreated. Frozen shoulder can be diagnosed in the clinic from your clinical signs and symptoms. A cli Continue reading >>

Bothered By Intense Shoulder Pain? Tips To Get Rid Of It

Bothered By Intense Shoulder Pain? Tips To Get Rid Of It

Bothered by intense shoulder pain? Tips to get rid of it Finding a cause for your shoulder pain is one of the most important things that your doctor can help you with.(Representative Image) The shoulder is a complex ball and socket joint that is able to move in many directions. With this great mobility comes a lack of stability .The lack of stability in the shoulder makes it susceptible to injury and pain. Pain in the shoulder is the most common complaint from patients. Finding a cause for your shoulder pain is one of the most important things that your doctor can help you with. This can treat your pain and also help you prevent it in the future. Pain in the shoulder joint can be a manifestation of problems within the shoulder joint or problem with the tissues surrounding the shoulder and rarely a referred pain due to structures that are away from the shoulder such as like cervical spine, heart , lung and diaphragm. -Poor Posture: Poor posture in sitting or standing position can cause shoulder pain. If you have a rounded shoulder posture, the shoulder joint is placed in a position where the bursa (a fluid filled sac, which acts as a cushion between the bones and the muscles), muscles and tendons in the shoulder can be pinched. Sit with poor posture (hunched back and let your shoulders sag forward). Then try to lift your arms up overhead. They probably will not go very far and the strain will be felt in the shoulders. Then sit in good posture (back upright with the shoulder blades pulled back) and raise your arms again, and you will find that the arms can reach fully overhead with no strain. -Repetitive overhead activity: While reaching overhead, the space between the shoulder tendon and the shoulder blade decreases. The tendons can then get pinched underneath the bony Continue reading >>

Frozen Shoulder In Diabetes

Frozen Shoulder In Diabetes

Tue, 03/29/2011 - 12:09 -- Richard Morris By Paul Schickling, RPh, CDE, and John Walsh, PA, CDE Long term complications of diabetes may include changes in connective tissue that occur as a result of high glucose levels. Adhesive capsulitis, often referred to as frozen shoulder refers to a pathological condition of the shoulder joint which causes a gradual loss of motion usually in just one shoulder. Adhesive capsulitis (AC) has a prevalence of 2% in the general population, but is reported to occur in 10 to 29% of those with diabetes. Studies have shown it is caused by glycosylation of the collagen within the shoulder joint triggered by the presence of high blood sugars. Dupuytren's Contracture of the palms and fingers of the hand is another example of contracture syndrome related to diabetes. It is sometimes referred to as stiff-man syndrome although it occurs in both sexes. Stage 1: The Initialization Stage has a duration of 0 to 3 months is associated with pain and reduced range of motion (ROM). It may be noticed when the person can no longer do things like comb their hair or reach a shelf above their shoulder. Pain is described as achy at rest and at night. Arthroscopy and biopsy reveal joint changes and an influx of inflammatory cells. Evaluation is important to establish reference points for later assessment of the progression of the disease. Treatment goals are to lessen pain and inflammation by use of nonsteroidal anti-imflammatory drugs (NSAID) like aspirin and ROM exercises. Stage 2: The Freezing Stage, which lasts from 3 to 9 months, presents itself with chronic pain and further reduced ROM. This stage moves from the inflammatory stage to the fibrotic process. X-rays reveal decreased joint space. Treatments may consist of NSAIDs and corticosteroid injections. Continue reading >>

Diabetes And Shoulder Disorders

Diabetes And Shoulder Disorders

Musculoskeletal disease is one of the most common complications in patients with diabetes, and yet is receives relatively little attention. The severity and the risks of musculoskeletal complications might not be well recognized as cardiovascular complications; however, the associated ailments certainly inflict both physical and psychological harm on people with diabetes. Among the various musculoskeletal diseases, shoulder pain is one of the most common complaints. In general, it is characterized by pain and limited range of motion of one or both shoulders. Shoulder pain not only causes decreased quality of life, but also leads to disability in daily activities, and might interfere directly or indirectly with control of metabolic processes. Previous reports showed that there is a higher prevalence rate (27.5%) of shoulder disorders in patients with diabetes as compared with the rate of 5.0% found in general medical patients1. Two of the most common shoulder disorders are frozen shoulder, also known as ‘adhesive capsulitis’ and rotator cuff disease. Frozen shoulder is characterized by progressive pain, stiffness, limited active and passive range of motion of the shoulder joints, especially external rotation, and night pain. Although the exact causes of frozen shoulder are still underexplored, it is generally believed that frozen shoulder develops as a result of perivascular inflammation and fibroblastic proliferation, followed by capsular fibrosis and contracture. It is worth noting that primary frozen shoulder is idiopathic and secondary frozen shoulder might be associated with previous shoulder injury, such as rotator cuff injury, trauma or prolonged immobilization. Clinically, frozen shoulder is diagnosed by history and physical examination. Current available man Continue reading >>

Frozen Shoulder And Diabetes

Frozen Shoulder And Diabetes

Frozen Shoulder or Impingement? What is the connection between frozen shoulder and diabetes? A frozen shoulder seems to result from the way the brain responds to inflammation around the long head of the biceps in the rotator interval. In some people, and we still don’t know why, the brain over-reacts to this inflammation by switching off groups of muscles and changing their dynamics. We do know however, that frozen shoulder is much more common in diabetics. About 20% of diabetics are affected compared to around 5% of the general population. It is not clear why this should be the case but experimental studies have shown that the soft tissues of the shoulder are stiffer than normal. Collagen All muscle fibers are ‘packed’ within other tissue called parenchyma. This packing substance is made of collagen. Collagen helps to make up the elastic component of the skin and muscles (ex. as we get older our skin wrinkles as a result of decreased collagen production). US doctors NA Friedman and MM LaBan published a paper in 1989 in which they put forward two theories as to why frozen shoulder is more common in those suffering with diabetes. Diabetes and Frozen Shoulder - Theory 1 Because Type I diabetics are unable to regulate their blood sugar levels naturally, there are many times during the day that the sugar levels may be high, which can lead to an accumulation of sugar-alcohol in the tissues. This sugar-alcohol is called sorbitol and it accumulates in the ‘ground substance’ of the connective tissues (collagen) where, because it has a higher osmotic pressure, it attracts water, making the tissues stiffer. Diabetes and Frozen Shoulder - Theory 2 An alternative explanation has been put forward, whereby the properties of the collagen itself are attenuated. It has been su Continue reading >>

Shoulder Manifestations Of Diabetes Mellitus.

Shoulder Manifestations Of Diabetes Mellitus.

Abstract The musculoskeletal system can be affected by diabetes in a number of ways. The shoulder is one of the frequently affected sites. One of the rheumatic conditions caused by diabetes is frozen shoulder (adhesive capsulitis), which is characterized by pain and severe limited active and passive range of motion of the glenohumeral joint, particularly external rotation. This disorder has a clinical diagnosis and the treatment is based on physiotherapy, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections and, in refractory cases, surgical resolution. As with adhesive capsulitis, calcific periarthritis of the shoulder causes pain and limited joint mobility, although usually it has a better prognosis than frozen shoulder. Reflex sympathetic dystrophy, also known as shoulder-hand syndrome, is a painful syndrome associated with vasomotor and sudomotor changes in the affected member. Diabetic amyotrophy usually affects the peripheral nerves of lower limbs. However, when symptoms involve the shoulder girdle, it must be considered in the differential diagnosis of shoulder painful conditions. Osteoarthritis is the most common rheumatic condition. There are many risk factors for shoulder osteoarthritis including age, genetics, sex, weight, joint infection, history of shoulder dislocation, and previous injury, in older age patients, diabetes is a risk factor for shoulder OA. Treatment options include acetaminophen, NSAIDs, short term opiate, glucosamine and chondroitin. Corticosteroid injections and/or injections of hyaluronans could also be considered. Patients with continued disabling pain that is not responsive to conservative measures may require surgical referral. The present review will focus on practice points of view about shoulder manifestations i Continue reading >>

Patient Education: Frozen Shoulder (beyond The Basics)

Patient Education: Frozen Shoulder (beyond The Basics)

FROZEN SHOULDER OVERVIEW Frozen shoulder is a condition that causes shoulder pain and limits the shoulder’s range of motion. The limitation in movement affects both active and passive range of motion. That means that your movement is restricted at the shoulder joint both when you try to move your own arm and when someone else (such as your doctor) tries to move your arm for you. Frozen shoulder is also called “adhesive capsulitis”, “painful stiff shoulder”, and “periarthritis”. We will use the term “frozen shoulder” throughout this article. EPIDEMIOLOGY Frozen shoulder is a fairly common condition in the general population. The condition is most common in people in their 50s and 60s, and rarely affects anyone younger than 40. Women are more often affected than men. Frozen shoulder usually affects only one shoulder (left or right) and gets better on its own, but it can last two to three years or even longer. People who get frozen shoulder on one side can go on to develop it on the other. FROZEN SHOULDER CAUSES Frozen shoulder often happens as a result of a shoulder injury, such as a rotator cuff tear, a bone fracture affecting the shoulder, or shoulder surgery. It can also happen after people have other types of surgery, such as heart or brain surgery. Frozen shoulder can also happen without a preceding injury and tends to preferentially affect people with certain diseases and conditions. People with diabetes, for example, have an increased risk of developing frozen shoulder. In fact, 10 to 20 percent of people with diabetes develop the condition. Frozen shoulder also seems to be more common among: People who have been immobilized for prolonged periods People who have had a stroke People who have Parkinson disease People who have taken antiretroviral me Continue reading >>

Shoulder Impingement & Frozen Shoulder

Shoulder Impingement & Frozen Shoulder

Has anyone here experienced one or both of these? I've had issues with my shoulder for at least 2 years. I had to go to 3 orthopedic doctors before I could find one who would listen to what I was saying (yes - that took almost 2 years, but I'm smarter now). Anyway - he diagnosed me with impingement in my shoulder and gave me stretching exercises and a cortisone shot (ow - like I don't take enough shots!!! ). The shot lasted maybe 2 weeks at best, and at my appt two weeks after that, he said to keep stretching and wait as long as possible for the next shot, as there's a limited number he can give me. Two weeks early (last Monday) I went back in for my second shot, where he told me if the shot doesn't help, then surgery won't either. If that shot helps for a little while, then we'lls tart talking surgery (which scares the heck out of me!! ). If it doesn't then he'll set me up with a shoulder specialist who can do "releases", whatever those are. Problem is - I seem to have gotten a little mobility back, but it hurts so much I'm getting nauseus more and more. Has anyone here been thru the "shave down bone in the shoulder" surgery, or have any idea what "releases" can be done for Frozen shoulder, which I'm heading to at a fast rate. And - why is this supposedly a common problem for Diabetics? Outside of a dog, a book is man's best friend. Inside of a dog, it's too dark to read... D.D. Family T1 for 54 years - on Pump since 03/2008 I had frozen shoulder for 8 yrs. I tried every therapy under the sun with no results, was told it was a diabetic problem & needed surgery. I was told to drink more water by this specialist, and & after 2 wks it went. Dunno - maybe it was just a coincidence. i had frozen shoulder, also called adhesive capsulitis. it lasted for about 18 months. had Continue reading >>

Injuries Related To Being Active With Diabetes: Part 3 (arm And Shoulder Injuries)

Injuries Related To Being Active With Diabetes: Part 3 (arm And Shoulder Injuries)

By Sheri Colberg, Ph.D., FACSM Arm and Shoulder Injuries The most common problems affecting the arms and shoulders are carpal tunnel syndrome (wrist), tennis elbow (lateral epicondylitis), rotator cuff tendinitis in the shoulder, and frozen shoulder (i.e., adhesive capsulitis). Most, but not all, involve tendinitis, which occurs more commonly in people with diabetes because of glycation of collagen structures in joints that limits their mobility and results in minor swelling and inflammation of tendons. Others involve impingement syndromes or inflammation of other joint-related structures. Carpal Tunnel Syndrome Carpal tunnel syndrome results from a squeezing of the median nerve, which runs from your forearm down into the palm of your hand. That nerve controls sensations to your thumb and most fingers, as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel is a narrow passageway that contains ligaments, tendons, and the median nerve. When the area becomes inflamed from overuse, the nerve is compressed, resulting in pain, weakness, or numbness in your hand and wrist that can radiate up your arm. Symptoms often first appear in one or both hands during the night because sleeping with flexed wrists aggravates the condition. Your grip strength will suffer. Forming a fist, grasping small objects, or doing other things with your hands may become more difficult. Carpal tunnel syndrome is more common in the dominant hand and more common in women because their carpal tunnel area is smaller. Contributing factors include trauma or injury to your wrist that causes swelling, mechanical problems in your wrist joint, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause, among others. Carpal tu Continue reading >>

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