So I was diagnosed with "frozen shoulder" about 3 months ago. I have been in pain for about 8 months now but now since physical therapy didn't do much they are going to do a shoulder manipulation. I have read though that frozen shoulder is common in type 1 diabetics (affecting about 20%) and that usually manipulation isn't enough that they need actually arthroscopic surgery....anyone have any experience?
I've never had a frozen shoulder, but I'm a PTA (physical therapist assistant) and have worked with patients with them. From what I've seen, if therapy doesn't work, a manipulation will as long as you keep doing you stretches/therapy afterwards. Keeping up with your home stretching program is key. You will probably be doing the same or similar exercises as you are doing now.
So you have worked with diabetics as well with the manipulation? That is good news.
I've never worked with diabetics specifically after a manipulation, but I wouldn't think it would be any different than a non-diabetics recovery =)
I know two people with frozen shoulder. Both are older Type 2's. It usually goes away on its own. Shoulder surgery is nasty. You should really be cautious about having shoulder surgery. Both people were strongly cautioned against it. I met a guy that had shoulder surgery at Diabetes camp last summer and he was miserable. He really regretted it. He looked like he had been shot in the shoulder.
I have had this in both of my shoulders, about five years apart, in the 1980s-1990s. I did not have any surgery either time. The longer you wait after the pain begins, the harder it will be to eliminate the problem. I waited a long time with my first incident, and it took a year of exercises with weights and supervision by a therapist, two visits per week, and follow-up exercising at home every day. That shoulder was 100% normal after the year was up. When the second shoulder was frozen, I started therapy much sooner. The treatment was much different, massaging and manipulation was used. It did not seem to be helping, but don't conclude it would not help you. I was not particularly pleased with my therapist. I quit the therapy and took care of it at home. I went through the exact routine I had used with the other shoulder, and did it all at home. That shoulder was normal after six months or so.
Not to go off topic but erica your a PTA?? I was looking into starting the PTA program at my school in the fall lol If you dont mind could you give me a little in site to the job and getting into the field.
I've had frozen shoulder twice and both times had injections of cortisone (1/2 doses). The injections helped temporarily but not long term, at least for me. What finally worked for me was going to physical therapy and having the PT massage and pull, and do several kinds of stretches &N exercises. I had to go to therapy 2-3 x's a week for about 4 months. Eventually the shoulder got much better and today I have full range of motion. I'm glad I didn't go the surgery route; I try to avoid that option if I can. At its worst, the frozen shoulder was very painful and I had trouble giving insulin injections (pre-pump days) in my hips. I'd definitely advise going to a phyical therapist and see what he/she suggests you do.
I've had this in both my shoulders. The first one (left) took about 8 months to heal completely. I tried stretching and light weights to improve it. That did not help. My endocrinologist (not a diabetic) had had the same. His advice was to let it run its' course. He strongly advised against surgery indicating that the condition would resolve itself. I hadn't expected this to occur on the other shoulder, but it did about 1 year later. That shoulder took longer to heal - about a year. Hopefully I've done my time now and this won't reoccur - I don't know. My endocrinologist doesn't think it will. ,At present, I'm just fine and have little/no loss of range of motion in either joint. Over the last year I've become a yoga enthusiast and my shoulders aren't holding me back.
Good luck Nicole - I think it will pass in time with no lasting harm.
I have never heard that frozen shoulder is common in type 1 diabetics. Does anyone know why that is?
Antonietta,
I'm a PTA and I love it! I've been working in this field for about 2.5 years.
I work primarily in an outpatient clinic, but occasionally in the hospital and nursing home settings. Basically, I treat people of all ages, from babies to the elderly, for a wide range of diagnoses. I help people with congenital diseases/abnormalities (something they were born with, like cerebral palsy, torticollis, etc.), neurological issues (stroke, traumatic brain injury, brain tumor, etc.), sports injuries (ACL tears, fractures, etc.) occupational injuries (work-related), and orthopedic surgeries (rotator cuff repair, total knee replacement, total hip replacement, hip fracture, shoulder fracture just to name a few). I work with almost any body part from the foot, ankle, knee, hip, back, neck, and shoulder. Where I work, occupational therapy mostly focuses on elbow, wrist, and hand problems.
There are many settings that you can work in. Outpatient will give you the most variety and excitement in my opinion. Acute is hospital work, mostly just getting people up to walk and the occasional exercises laying in bed. Sub-acute is also in a hospital, but only for certain diagnoses (usually people that need intensive therapy for an average of 2 weeks). Nursing homes are usually not the most desirable, but usually pay the most. In nursing homes, you work with patients for a set amount of time (30-60 minutes per day usually) and do exercises and walking. There is also home health, where you travel to people's homes to do therapy, and school therapists that work with kids during the school day. As you can see, there are many different choices and all are very different!
I went to school at Stark State College and I live in NE Ohio. When I went, there was a 1-year waiting list to even get into the program, so it took me 3 years total to finish. You will graduate with an Associate's degree. At that same college, there is now a 2-3 year waiting list! The field is growing very quickly and PT's and PTA's are in high demand!
Every day is different and presents with it's own challenges, but overall it's an extremely rewarding career! I recommend it to anybody that is willing to work hard, is a "people person", and is passionate about helping others!
I forgot to explain what outpatient is! Where I work, people come in for 30 minutes at a time and this is where you see all ages and problems. You never know what diagnosis you're going to see next, so there's a wide variety and there are many challenges! It's what I really love!
I had my left shoulder freeze about four years ago. It was two years of pain (the first year was undiagnosed). PT didn't really help. A shot of cortizone helped with pain, but of course caused need for lots more insulin. That one I was able to get back full motion... it took two years, no manipulation.
About a year ago, my right shoulder started bugging me while sleeping. By the time I figured it out, it had frozen. I tried cortisone shot in May and it helped with pain, but within four months I was miserable. I had a manipulation done in November 2010. They did arthroscopic while I was under and my orthopedic surgeon said it was full of crud he has to scrape out. After surgery, I had five days straight of PT. Then three times a week for a month, then two times a week for a month. I just stopped PT at the end of Jan. My problem this time has been shoulder muscle issues - there is a muscle that keeps knotting up on my scapula. Finally figured out with the help of one of the PTs that my neck was out of alignment. Got that back in and it felt better, but if I over-use shoulder (i.e. snow-blowing & shoveling) now, the next goes out of alignment & shoulder knots up. I have gone to a chiropractor a few times and they are helping to get it back in line. I'm not 100% but sleeping is almost back to normal. I'm still on anti-inflammatory (ibuprofen doesn't help... they had to step it up). Bio-freeze gel helps a TON too. I"m not at 100% motion back yet, but 95%, I'd say.
Having been through PT with the first time, I can say PT this time was better... actually felt like I was doing something other than making shoulder more painful. I am happy to have done the manipulation and from the pictures the orthopedic took of shoulder, it makes sense how the should would likely re-freeze if they left all the gunk in there.
Brianna,
Here's a link to the ADA website with information about frozen shoulders and diabetes. I'd never heard that diabetics were at a higher risk for developing this either - it's very interesting.
http://www.diabetes.org/living-with-diabetes/complications/related-conditions/frozen-shoulder.html#"
Oh you guys thank you!!!!! It makes me feel like I am not alone. My Orthopedic surgeon said that they tend to heal themselves in about 1-3 years and sometimes a little longer for diabetics especially type 1's. I did the PT religiously for a straight month once a week and once a day at home. It did start to feel a little less painful until "life" kicked and for my job I had to put safety tape on the ground so I was ripping off the old and my left shoulder SCREAMED at that motion. I also caught my hand on the back of my sleigh bed coming a round the corner so my body was going forward and my hand caught the lip of it and jerked me back....that brought me to my knees!!!!
I agree I don't want surgery but if it takes me out of pain and lets me put my coat on by myself and insert my CGM then I will do it. The manipulation isn't surgery. They just put you under for about ten minutes and break up all the scar tissue that is formed around your scapula manually. KATIE: so how did they know to do arthroscopic when they were going in for a manipulation? I read that too, that sometimes the shoulder after manipulation will re-freeze?
I have had trigger finger twice (both hands middle fingers) I got a cortisone shot in one and my blood sugars went sky high. A little thing they forgot to mention to me. After my first finger, my doctor said that he doesn't like to give cortisone shots to diabetics because it just temporarily lessons the pain for a couple weeks. Nice.
Nicole
Thanks for the link, Mal. That is interesting, and definitely something I didn't know!
It seems like there is no part of the body that is immune from diabetes wrought havoc. Sigh.
[quote user="Nicole2711"]
KATIE: so how did they know to do arthroscopic when they were going in for a manipulation? I read that too, that sometimes the shoulder after manipulation will re-freeze?
[/quote]
My surgeon wanted to see how the shoulder moved when I was under and he was going to make the determination based on how it moved. Once he started moving it, he could feel where the non-smooth motion was and knew he had to go in to clean it up. My surgeon also did a shot of cortisone while he was in there for the surgery... but he did a 1/2 dose knowing it would help but also cause BG issues. I needed 133% of insulin basal rates for the next week.
The PT schedule they have you on after surgery should take care of the not freezing up. You have to move it, so if it's painful ask for medication to help. I stopped the pain killers after two days but stayed on the anti-inflammatories. Realized after a few weeks that ibuprofen wasn't really helping me sleep (guessing it was after the cortisone wore off), so I bumped up to relafen. That didn't do anything so now I'm on voltaren - it has helped me keep it moving during day and actually sleep at night (!!! sleep at night is awesome!). Not every anti-inflammatory works for everyone so you may need to try multiple.
I've had frozen shoulder a couple times. Noticed it usually starts when my blood sugars are higher than normal.
So try to have fewer highs. It feels like your arm can't move, but movement is what will heal the problem. Try stretching your arm and doing other PT exercises while in the shower. The warm, humid air makes the muscles easier to manipulate.
Katie, thanks. I wonder if they will consider that when I am under. I have wondered if it could be more than just frozen shoulder because of other symptoms and pain I have had previously. The MRI I had showed Tendonitis/Bursitis and inflamation of my bicep muscle.
How long were you off work for? I guess if they just manipulate it, I won't have as much pain as if they go in and clean it out. I will keep moving it. I dont want it to freeze up again....I am scared of that and of my right shoulder getting it. :)
I will work on keeping my blood sugars down and try to get my a1c under 7. I know that will be tough but since I don't want anymore complications and I want to get pregnant I better just keep being persistent.
[quote user="Nicole2711"]How long were you off work for? [/quote]
Had surgery on Tuesday and went back to work the next Monday. My A1C has been 6.5 - 7.1 for the past five years - and I got both frozen shoulders during that time. They aren't sure why people with type 1 have a higher chance of developing frozen shoulder. They said maybe circulation - but I don't have any issues in my feet, etc. so it's hard to believe my shoulders would. I read somewhere in my research online that the general population has less than 1% chance of developing adhesive capsulitis (frozen shoulder) but people with type 1 are closer to 40%.