What is Frozen Shoulder/Rotator Cuff Syndrome?

The Rotator cuff is the group of muscles that surround the shoulder which control all the shoulder movements. Rotator cuff syndrome refers to the disease spectrum of the rotator cuff and frozen shoulder represents the most severe form of shoulder rotator cuff syndrome, causing severe restriction of all the shoulder movements, aka “frozen”, and hence the term “frozen shoulder”. The patients will have great difficulty lifting the arm and performing other overhead activities, leading to extreme limitation of the upper limb functions and daily activities.

Symptoms

The initial symptoms of rotator cuff syndrome are usually shoulder pain and weakness. The pain is usually most pronounced during overhead movements. Sleep is greatly affected as well as the patient is frequently awakened at night when he/ she tries to sleep on the affected shoulder. The patient will not be able to carry heavy loads on the affected limb as well. If treatment is not initiated, the disease will progress and finally leading to severe restriction of the all the shoulder movements, and finally “frozen”. The cause of the rotator cuff syndrome is typically due to injuries, either a major fall/ twisting injuries or the accumulation of multiple repetitive injuries. It is more common in the middle-aged individuals but it can also affect young athletes who engage in overhead throwing sports.
rotator cuff syndrome graphic

Assessment

At Dr Henry Chan’s Orthopaedic Clinic in Singapore, we will take a thorough history, physical examination, X rays and MRI scans to confirm the diagnosis and investigate any tear of the rotator cuff muscles, as well as the exclusion of other causes of referred pain such as cervical spondylosis or slipped disc in the cervical spine.
rotator cuff syndrome treatment ultrasound

Treatment

Depending on the severity, the shoulder pain treatment is individualized and can be divided into:

  1. Non-operative
    • Anti-inflammatory drugs
    • Dedicated physiotherapy
    • Anti-inflammatory medication injection (H& L)
    • Ultra-sound treatment
  2. Surgery
    • Arthroscopic sub-acromial decompression
    • Arthroscopic rotator cuff repair

The aim of treatment is to relieve the pain, alleviate the suffering and to restore the movement and the function of the affected shoulder.

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