Diabetic Frozen Shoulder

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Permalink Reply by Michael Wiggins on June 22, 2009 at 10:36pm

Steve,

I am headed to a Orthopedic specialist on July 5th for what appears to be similar ailment. They ruled out rotator cuff, tedontitis, and bone issues with x-rays. I usually sleep for 3 hours a time. Yours is a new diagnosis to me. I have been a T1 for 35 years. I'll let you know what I find out - I am ready for cure even if surgical.

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Permalink Reply by Holger Schmeken on June 23, 2009 at 1:06am

The frozen shoulder could be related to diabetes. But I know three non diabetic women who have developed a frozen shoulder in the last three years (no family relations between them).

The biggest problem seems to be that the inflammatory process in the shoulder is causing the shoulder cap to get very tight. This tightness leads to less blood flow and less blood flow fuels the inflammatory process. So the condition gets worse over time.

Two of the women I know had intense physiotherapy over 1/2 to 1 year. Still one had to have surgery because the inflammation damaged the rotary muscle ring of the shoulder.The women without therapy recovered over three years from this condition but she still has pain when specific movements are involved.

In general I would say that it takes a whole lot longer than you already think. Intense physiotherapy is a good advise. But in my opinion if it is really painfull I would ask the shoulder specialist for a surgery. The shoulder cap could be (I dont know the exact medical term) grated to relief the tightness and to stop the inflammation.

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Permalink Reply by Jenny on June 23, 2009 at 4:54am

I have had two different frozen shoulders and have done some research about them.

It turns out that you can have intensive, painful physical therapy and expect them to start to clear up in about six months or you can do absolutely nothing and expect them to clear up in about six months.

My own experience was that that very painful phase lasted about 6 weeks. The second one I got was especially painful as it trapped a nerve and I was in pain all the time. My doctor prescribed heavy duty pain pills which helped with sleep. I even went to an orthopedic surgeon who told me that it was one of the most inflammed frozen shoulders he had ever seen and that he could not operate on it because I could not have done the rehab.

But it got completely better over time!

Oddly both of my frozen shoulders occurred a few months AFTER I had made significant improvements in my blood sugar control. The first followed my initial diagnosis--I have a genetic form of diabetes where my blood sugar had been pre-diabetic since I was first tested 30 years ago, and the frozen shoulder started after I dropped it dramatically with a long term very low carb diet.

The second one followed in the year after I started using insulin at meal times and dropped my post-meal two hour numbers from over 140 to 100-ish.

I found that acupuncture was very helpful with my first frozen shoulder, but not in the acute inflammatory phase. That shoulder got very immobile after 6 months, and two acupuncture treatments freed it right up. But the acupuncture did not do anything for the acute inflammation in the second. The acupuncturist said that my muscles had gone into spasm in response to the previous inflammation which is why the treatment worked.

Finally, I let a doctor talk me into a cortisone shot on the first one. It did terrible things to my blood sugar and nothing for the shoulder.

Hang in there. Frozen shoulder almost always resolves on its own. If you are having pain ask the doctor for a prescription strength pain/inflammation drug. I can't take NSAIDS but if you can, they should help, too.

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Permalink Reply by Joan Powers on June 23, 2009 at 5:38am

I have been a T2 diabetic for 9 years and last spring developed frozen shoulder. However, they took x rays and an mri first and determined that I had a small tear in my rotator cuff. I hadn't remembered having any kind of injury, but they said it could be caused by making repetative movements, which I did do. So, having the tear was painful which caused me to baby that shoulder, and that in turn froze it. They sent me to physical therapy and said this would be a process of no pain, no gain. I went for about 3 months, 3 days a week. Progress was slow but steady, and not as painful as I thought it would be. I can't say that I'm 100 percent better but I can reach behind my back and grab my other hand, I can raise my hand all the way up and sideways without too much pain. Putting heat in the armpit and over the shoulder helped a lot for pain, and doing that just before therapy was a great help. I still have the tear which is less painful as well. Not painful enough to go through surgery to fix it and then go to more therapy to keep it loose. They told me about diabetic frozen shoulder and said that no matter what causes frozen shoulder, long stints of physical therapy work best. There is a very painful surgery out there to fix it as well. My brother-in-law had it done and said it was horrible painful, but it was worth it to have it fixed more quickly.

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Permalink Reply by Jenny on June 23, 2009 at 6:55am

Well, we had an unintended "controlled study" in our family.

My brother had the frozen shoulder and did all the extremely painful PT stuff.

I left mine alone.

Identical healing time.

I did get the second one checked out to make sure it was not a rotator cuff tear as the Physical Therapist I saw thought it was a tear.

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Permalink Reply by Steve ODriscoll on June 23, 2009 at 3:08pm

Wow, many thanks everyone I feel slightly better knowing that it will get better and there is hope. Some nights and days even its so painful I want to pull my arm off as thought its a toothache (if you know what I mean). I was ironing a shirt for work and the stream wnet over my hand didnt hurt one bit but I reacted with pulling my hand away very quickly it was the frozen should are and the pain that went down my arm was the most intense I have ever ever had I dropped the iron and fell to the floor. I want it to go away more then my diabetes I think at the moment but have some hope it will get better Thank You for responding... x

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Permalink Reply by Jenny on June 25, 2009 at 4:09am

Steve,

That kind of pain is EXACTLY what I experienced with my second frozen shoulder. It started in September, by mid October I was living on pain pills and still hurting, but by December it had calmed down considerably and eventually it faded out completely. As far as "most painful thing I ever experienced" goes, it came in second to my 23 hours in obstructed labor, but that isn't something you'll have to worry about.

If it is a frozen shoulder rather than a tear nothing structural is permanently broken, instead as I understand it what happens is you get swelling, swelling pinches nerves, that causes muscle spasm to freeze the muscle around the injury to protect it.

Studies that I looked at found that cortisone shots did not improve the healing time. Since cortisone shots really screw up blood sugar control don't let a doctor push you into having them. I think they give you the shot so they can make you feel like you got something in return for the very expensive appointment.

If you're doing web research, the technical name is "Adhesive capsulitis."

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Permalink Reply by Jim Huck on June 23, 2009 at 4:02pm

Richard Bernstein refers to this in his book. Here is a link to an article he wrote about it.

The good news is that, according to him, it's reversable.

http://www.noaw.com/Frozen_shoulder/frozen_shoulder.htm

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Permalink Reply by Dena on June 23, 2009 at 6:23pm

I've struggled with this problem for years. If I made a quick movement, sometimes I would get such intense pain in my right arm that I would scream. Everyone in the house would come running. By the time they got to me the pain was losing it's intensity. It was awful. Cortizone didn't do anything except raise my bloodsugar. I did physical therapy for awhile. Finally opted for surgery. Subacromial decompression. I think they removed the end of my scapula to give everything in there more space. That did eliminate the extreme pain but I never totally recovered. I mean my shoulder is still tight and I do have to keep stretching it. Then, last year, my right shoulder began giving me trouble. I stretch it. The pain isn't as extreme so will not pursue surgery. Strengthening and stretching are important for everyone's shoulders. It helps prevent this problem to begin with. It also affects non-diabetic people but is very common in diabetics. I've been T1 for 39 years.

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Permalink Reply by Michael Wiggins on June 25, 2009 at 2:33am

Steve,

I'm up for upteenth time at night taking a pain pill. It hurts from my shoulder to my hand. My bloody doctors better better find a cure or a solution on the 5th. I try really hard not to need a pain pill - but what can I do it hurts so bad! Its starting to drive me crazy!!!!!!!!!!!!! What's your next step?

Mike.

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Permalink Reply by Michael Wiggins on June 25, 2009 at 2:54am

Steve,

I forgot to mention but the diagnosis I been given before see the Orthpodic folks is Inpingement Syndrome. After looking it up on the net seems to fit. Sounds like a few more diagnostic tests to confirm. Not sure how this relates to Diabetic Frozen shoulder. You might check it out yourself. Final cure at least from the net will be some sort of surgery - I am ready to enbrace this if its a cure. Mike

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Permalink Reply by Michael Wiggins on June 25, 2009 at 3:05am

Steve - see if this describes you - Mike

Each of these three conditions, shoulder impingement, tendinitis or tendonitis, and bursitis usually happen at the same time. As a result, the terms are often used interchangeably. The reasons why these conditions may not get better by themselves are related to the frequency with which the cuff is irritated and to the changes that occur in our bodies as we grow older. Repetitive activity that irritates the rotator cuff may increase the amount of inflammation, and the aging process makes it more difficult for the inflammation to heal. Doctors believe that the blood supply to the tendon may decrease as we get older, causing the tendon to get weaker and possibly making it more difficult for the body to heal small tears or inflammation.

While most patients usually try to ignore the first signs of pain, they often visit a doctor after the pain has started to prevent them from sleeping well. Shoulder pain that makes it difficult to fall asleep is a common symptom of impingement syndrome and rotator cuff tendinitis. Most patients with this type of shoulder pain do not have a history of a bad shoulder injury, a dislocation, or an episode of the shoulder giving way. At first, most people notice only minor pain and a slight loss of strength. Subtle changes in range of motion, and especially in the ability to lift the arm overhead, may be ignored for a while. However, as symptoms progress, the shoulder pain and limited motion become more difficult to ignore.

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