Sunil Purohit, 16, was not prepared for the sudden unexplained immobility in his right hand. The piercing pain was so distressing that he dreaded to even move his hand. Mona Verma, 56, knew she was in for trouble. The pain in her left arm was nothing she had ever experienced. Finally, she called up her cardiologist, expecting the worst.

Both Purohit and Verma were diagnosed with frozen shoulder. Who knows, if you are unaware of the first symptoms, tomorrow you too may fall prey to it. So if you are having trouble lifting your arm above your head, stretching it across your body, or reaching it behind your back, you better find out what it’s all about.

Limited motion is an early symptom of frozen shoulder. It is a general term denoting all causes of motion loss in the shoulder. A frozen shoulder, also called adhesive capsulitis, is a shoulder joint with significant loss of its range of motion. The condition begins with a gradual onset of pain and a restriction of shoulder movement. Sometimes, the discomfort can go to such lengths that even day-to-day activities become painful.

A frozen shoulder can be categorised as primary adhesive capsulitis and as secondary adhesive capsulitis. The specific causes are not yet known but the possible causes range from a change in the immune system to biochemical and hormonal imbalances.

Diseases such as diabetes mellitus and some cardiovascular and neurological disorders may also be contributing factors. A frozen shoulder may affect both shoulders and may be resistant to most forms of treatment. It may also develop from a known cause, such as stiffness following a shoulder injury, surgery or a prolonged period of immobilisation.

As far as vulnerability goes, anyone can have a frozen shoulder. But the risk factors are more for diabetics. Explains Ranen Dasgupta, specialist in endocrinology and diabetic disorders, “It is a collagen vascular disease. For diabetics, the risks are more because of the degeneration of muscles owing to glucose deposits.”

“A frozen shoulder can also be due to a cardiac pain fixed in the left hand,” warns cardiologist K.K.H. Siddiqui. “In such cases, the pain is on the lateral side, which then radiates to both the small and ring fingers. It may even affect the chest, jaw and teeth.”

Ten per cent of the total orthopaedic complaints and 40 per cent of upper limb disorders are due to frozen shoulders, points out Mukul Bhattacharya, associate professor, orthopaedic surgery, Calcutta Medical College. He adds, “It is an idiopathic disorder and is more common during winter. It is not age related but rather, work related. Cervical spondolysis is one of the commonest culprits. People who type or play power games are more likely to suffer from this kind of condition.”

Most cases of frozen shoulder tend to follow a specific pattern. Initially, the phase is characterised by acute pain, difficulty in sleeping and major functional impairment. This is followed by a stiffening phase when the shoulder motion gets further restricted.

Since there is significant variability in the clinical response to frozen shoulder treatment, such cases are handled on an individual basis. Juliet Ekkaa, physiotherapist at the Calcutta Medical Research Institute (CMRI), suggests, “Gradual exercises should be followed by ultrasound and other equipment-based pain relief procedures. Then, maintenance therapy with active exercises must be followed to relieve patients suffering from this kind of debilitating condition.”

Non-operative treatments include medication to reduce inflammation and relieve pain. Also, a programme of physical therapy ? often combined with home exercises and other therapies ? to stretch and restore motion can help. Heat and ice therapies are also effective. Sometimes, even corticosteroid injections are administered to alleviate the pain. It is important that you do stretching exercises several times a day.

Finally, arthroscopic surgery can successfully release and repair the shoulder, provided it is followed by an exercise programme.

So, if you are stuck with a frozen shoulder, don’t ignore it. Rather, go and see a doctor before it’s too late.

Treatment tips

• The root of the problem may not necessarily lie in your shoulder. For all you know, tight muscles somewhere else in your body are pulling at your shoulder and freezing it into place.

• Start with very small shoulder circles to loosen the shoulders. Do a few minutes on each side several times a day.

• Arm circles are less painful when you do them lying on one side. Make little circles in the air with the elbow and bigger circles when the shoulder feels less stiff.

• Tight leg muscles may be the root cause of your pain. Lie down in front of a doorway. Put one leg up the wall, arms resting at your side. Do a few minutes on each leg.

• Shoulder stretches can do wonders. Take a towel in your right hand and hold it behind your head as though you are holding a back scratcher. Wrap your left arm around your lower back so that the bony side of your left hand rests against your left lower back.

In this position, your left hand should be able to hold on to the bottom of the towel. Once both your hands are able to firmly hold on to the bottom of the towel, use your right hand to slowly pull the towel upward until you feel a good stretch in your left shoulder. Hold it for about 30 seconds and make sure that you don’t stop breathing. Then, slowly, pull the towel downward with your left hand until you feel a good stretch in your right shoulder. Hold it for 30 seconds and maintain steady breathing. Repeat the same in reverse.

• The single best method to strengthen the tendons around your shoulders is to hang on a bar. Even five to ten seconds a day can dramatically improve the strength of the tendons that surround your shoulders and your upper body in general.

• Include vitamin D and beneficial bacteria in your diet to strengthen your immune system. This will decrease the risks of developing conditions that have an auto-immune component.