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I am a 34 year old female who was diagnosed with Type 1 diabetes at the age of 3. I am living a full and healthy life with seemingly no complications from diabetes. I have noticed in the past year however, that my left shoulder has become stiff and increasingly painful. When I have talked with my doctor about this, he can find no real reason for the pain. I saw a line about something called frozen shoulder that strikes 11% of people with diabetes. Could you please give me some more information on this? What is frozen shoulder? What are the symptoms? Is there relief? Does it get progressively worse? What causes it? Do people without diabetes get it or is it only found in diabetics? Thanks you very much for your time.

In discussion with a friendly orthopedic surgeon whose office is down the hall, we learned that in people with adhesive capsulitis (his term for frozen shoulder), about 25% have diabetes! But, "frozen shoulder," medically known as adhesive capsulitis, fortunately is much less frequent in diabetes patients than the information you read would imply; it certainly doesn't seem to be in the range of 11% of all people with diabetes, as you found somewhere. He couldn't come up with any explanation why so many of the patients have diabetes.

He explained the technical problem in adhesive capsulitis is either a series of adhesions between the rotator cuff and the overlying subacromial bursa, or contractures between the muscles and the underlying joint capsule.

Symptoms of frozen shoulder include progressive loss of range of motion of the shoulder; the restrictions in motion is usually quite painful. Various treatments can be tried, including physiotherapy and anti-inflammatory medication.

If these don't work, sometimes manipulation of the joint (under general anesthesia!) can break the adhesions, and are combined with use of steroid medications. The orthopedic surgeon added that there are no good followup studies on the long-term effectiveness of these manipulations, although in the short-term, there's improvement of comfort and functional use with surgical treatment.

Original posting 18 Mar 96


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