Frozen shoulder, medically known as adhesive capsulitis (AC), is a painful and debilitating condition that is characterized by the progressive loss of passive and active shoulder range of motion. For those who have experienced it, they understand the frustration and discomfort that accompanies this condition- it’s not great. Some risk factors of AC are, rotator chug tendinopathy, biceps tendinopathy, chronic liver disease, breast or cervical spine surgery, and neurological disorders. The incidence of AC in the general population is 3-5%; though it sits at about 20% for individuals with diabetes. Right now, there are invasive and non-invasive interventions ranging from surgery or injections to physical therapy. In more recent years, researchers have been exploring the effects of various treatment options, and one promising avenue is laser therapy.
Understanding Frozen Shoulder
Frozen shoulder is characterized by the gradual reduction of range of motion and mobility in the shoulder joint. Mobility is decreased due to the volume of the glenoid capsule decreasing and development of fibrosis; thus, causing stiffness, pain, and reduced functionality. Adhesive capsulitis typically progresses through three distinct stages:
- Freezing Stage: This initial stage is marked by increasing pain and a gradual loss of shoulder mobility. The shoulder becomes stiff and painful, making everyday activities challenging.
- Frozen Stage: In this stage, the pain may decrease slightly, but the stiffness becomes more pronounced. Daily activities become severely limited as the shoulder’s range of motion diminishes.
- Thawing Stage: In the final stage, the shoulder gradually regains mobility, and the pain subsides. This stage can take several months to years, depending on the individual.
In many cases, frozen shoulder seemingly resolves and progresses through these stages in 2-3 years. Although in 40% of cases, patient’s experience the pain, stiffness, and immobility for longer than 3 years. Due to this, the search for effective treatment has been high.
Causes of Frozen Shoulder
The exact cause of frozen shoulder remains a subject of debate, but several factors may contribute to its development. Inflammation in the shoulder joint’s lining (synovium) can trigger the formation of adhesions and scar tissue, restricting movement. The progression of these can lead to immobility. Another contributor to the development of frozen shoulder is prolonged immobility or lack of use of the shoulder due to injury, surgery, or other medical conditions; which, can increase the risk. There have been other correlations such as medical conditions that have shown a greater correlation to frozen shoulder. As said prior, it is estimated about 20% of individuals with diabetes will develop this limiting condition. Thyroid disorders, heart disease, and Parkinson’s disease are also correlated with frozen shoulder. Sometimes, it even develops from a minor tendinitis or tear. Let’s get into how to help!
Laser Therapy and Frozen Shoulder
Laser therapy, also known as photobiomodulation (PBM) therapy, is a non-invasive medical treatment that uses low or high-intensity lasers to stimulate cellular activity. It has gained attention as a potential treatment for frozen shoulder due to its ability to reduce inflammation, alleviate pain, and promote tissue healing.
In a systematic review, low-level laser therapy has been strongly suggested for pain-relief, moderately for function, and not recommended for improved range of motion. The same review suggested therapeutic exercises were strongly suggested for improved range of motion and function. In more recent studies, high-level laser therapy has been thought to be able to penetrate deeper tissues and supply more energy, allowing for better results. A study we looked at compared the two, low level and high level therapy, and found that high-level laser therapy with therapeutic exercises had greater effects than low-level laser therapy with exercise in patients with adhesive capsulitis. It was found that after 15 sessions of high-level laser therapy plus exercises, pain was decreased significantly and quality of life was improved!
While laser therapy for frozen shoulder is a relatively new area of research, there have been promising findings in recent studies. High-level laser therapy increases cell metabolism, vascular permeability, and blood flow by penetrating energy into the cells. Further, the laser effectively decreases pain associated with frozen shoulder by stimulating the release of endorphins. It reduces inflammation by inhibiting inflammatory cytokines and stimulating the release of anti-inflammatory cytokines. These help reduce the inflammation in the shoulder joint- a crucial element of the development of frozen shoulder. Though range of motion has not been shown as a direct significant improvement, decreasing the pain and inflammation are important for the ability to complete therapeutic exercises in order to achieve ROM improvement.
Let’s Recap! What does this mean?
Frozen shoulder is a challenging condition that can significantly impact one’s quality of life. It can limit everyday activities, hobbies, and more- but before you dive into surgery, conservative treatments may be beneficial! Laser therapy offers a non-invasive and relatively risk-free approach to managing your pain, inflammation, and mobility issues associated with frozen shoulder! It has been shown to help increase quality of life for individuals with this condition!
If you or someone you know is suffering from frozen shoulder, it’s essential to consult with a healthcare professional to discuss the most suitable treatment options, which may include laser therapy. This conservative method could give you the chance to experience relief while you are working through exercises to regain function! Here you can schedule an evaluation with our highly-trained professional and see what treatment might look like for you!
Read more about the research we talked about here!