Pathofysiology associated with a frozen shoulder
A frozen shoulder can be classified in to a primary and secondary condition. The primary is known as a onset of idiopathic origin. The secondary has a more specific cause, such as diabetes or a rotator cuff disease. The duration varies from 1 to 3.5 years.
The aim of this study was to create a summary of all the literature available regarding a frozen shoulder.
This article highlights the role of the anterior shoulder structures in a frozen shoulder, however the understanding of the pathofysiology remains unclear. Further research is necessary to understand the condition.
Previous studies have linked an immunological component to the frozen shoulder. Such as the presence of B-lymphocytes, mast cells and macrophages which may eventually lead to an imflammatoiry synovitis.
The majority of studies suggests that the anterior region of the shoulder shows the most pathological changes in a frozen shoulder using medical imaging. The study suggests a fibroblastic profileration of the capsula. Another finding in this study was an increased vascularity in the anterosuperior structures, but abscent in the inferior structures.
Most treatments consist of injecting medication (i.e. NSAIDs) into the joint space. However, when repeated often, this can reduce tensile strength, collagen fibre organisation and fibroblastic profileration.
A frozen shoulder shows changes regarding inflammation and vascularisation. These symptomologic findings are a lead for further research.
The current study does not suggest any new treatment options.
> From: Ryan et al., BMC Musculoskelet Disord 17 (2016) 340(Epub ahead of print). All rights reserved to The Author(s). Click here for the Pubmed summary.