Frozen Shoulder and its Link to Diabetics

Most diabetics lead productive and healthy lives, yet more than one third of the diabetic patients suffer from primary frozen shoulder.  

What it Means
We never hear about frozen knees or frozen hip, so it’s imperative to know why it is peculiar to that joint only, reveals Consultant Orthopedic Surgeon Dr. Bhuvaneshwar Machani. He explains, “As there isn’t any particular cause of the frozen shoulder, it can be very difficult to prevent it in most cases, though sometimes this can also happen following shoulder surgery or trauma, head injury, or radiotherapy.”  

Stages
There are primarily four stages of the frozen shoulder, the inflammatory stage where the pain slowly becomes worse, the frozen stage where the pain slowly improves becoming slightly less painful, but the shoulder becomes stiffer. This stage lasts for about three to six months after the first stage, the thawing stage where the ability to move the shoulder improves significantly with practically no pain, but the shoulder remains still very stiff and the recovery stage where the movement starts coming back on its own. The whole of this process from beginning of the symptoms till the recovery stage can take up to 24 to 36 months however, some patients might recover quicker. This, adds Dr. Bhuvaneshwar, is the normal process in over 90 percent of the patients, however, diabetic patients, especially those on insulin (type 1) may not recover as quickly or they may not recover at all. 

In Diabetics
According to Dr. Bhuvaneshwar, this condition is more common in diabetic patients. “Diabetes is very common in the UAE, more common than most people think and frozen shoulder has a direct association to diabetes,” he says. “Therefore, diabetic patients should be careful and should keep the blood sugar levels under control to avoid all complications.”  

Treatment
There are principally two ways to treat the frozen shoulder and get the movement back. First, Dr. Bhuvaneshwar explains is to place the patient under general anesthesia and then just bend (manipulate) the shoulder with controlled aggression. This process is very risky as you are unaware of what has been damaged inside apart from the capsule. Therefore, it is advisable to go for the keyhole or Arthroscopic Surgery, which is performed using a camera called an arthroscope. “In this surgery, an endoscope is inserted into the joint through a small incision,” he tells, so, you exactly know which ligaments you are divided and there is no damage to other structures. This can be uncomfortable with pain for few days following the procedure, but the results are very fruitful.